DIAGNOSTIC RADIOLOGY PROFILE



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DIAGNOSTIC RADIOLOGY PROFILE GENERAL INFORMATION (Sources: Perspectives on Health Occupations, the Canadian Medical Residency Guide and Pathway Evaluation Program, Royal College) Diagnostic radiology is concerned with the use of imaging techniques in the study, diagnosis and treatment of disease. The radiologist s major role is as a consultant to other physicians. By interpreting medical images produced by X-rays (radiography and computed tomography), radioisotopes (nuclear medicine), ultrasound (sonography), and magnetic fields (magnetic resonance imaging), the radiologist along with the referring physician and patient plan, organize, integrate and interpret the imaging studies to form a diagnosis and determine the course of treatment. Diagnostic radiology is an intellectually challenging and rapidly changing specialty. Therefore, radiologists must continue to study and attend educational courses to keep abreast of new information and techniques. To be effective, the radiologist must have considerable and detailed knowledge of anatomy and pathology, as well as sound knowledge of medicine and surgery. In order to use the sophisticated tools of radiology, they must also have a sound knowledge of physics and how images are formed. Radiology encompasses many subspecialties, including neuroradiology, ultrasound, MRI and CT, mammography and GI radiology.

DIAGNOSTIC RADIOLOGY PROFILE Interventional radiology is becoming a rapidly growing area within this specialty. Specially trained radiologists can now perform minimally invasive procedures, such as biopsies, drain abscesses, dilate stenotic arteries (angioplasty), clot bleeding arteries, remove biliary or urinary tract stones and insert central lines. Upon completion of medical school, it takes an additional 5 years of Royal College-approved residency training to become certified in diagnostic radiology. The 5 years of training require a closely supervised practice in the beginning, with the opportunity for increasing responsibility in the final years. This is to ensure that the resident can function near the end of training as a general radiology consultant, requesting help from staff radiologists when necessary. The residency may be followed by 1 or more years of fellowship training in a subspecialty discipline. The 5 years of training must include: 1 year of basic clinical training to give the resident a degree of independent responsibility for clinical decisions; an opportunity for further development of the skills required in making effective relationships with patients; the consolidation of competence in primary clinical and technical skills across a broad range of medical practice; and an understanding of the nature of the relationship between a referring physician and a clinical radiological consultant

DIAGNOSTIC RADIOLOGY PROFILE 3 years of Royal College-approved resident training in "general diagnostic imaging"; this must include: respiratory, cardiovascular, gastro-intestinal and biliary, genito-urinary, musculoskeletal, mammography, neurological and pediatric radiology, as well as the following modalities: fluoroscopy, ultrasound, nuclear medicine, and CT, MR imaging 1 year of Royal College-approved residency that may consist of 1-12 month periods in any of the following: further training in diagnostic radiology; diagnostic ultrasound; CT; MR; nuclear medicine; cardiac and/or vascular radiology; interventional radiology; neuroradiology; pediatric radiology; pathology or other clinical specialty relevant to the practice of radiology (for up to 3 months) or a full-time research project, relevant to diagnostic imaging For more detailed training requirements go to: http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route Canadian Association of Radiologists: www.car.ca

Number of physicians and physicians/100,000 population in Diagnostic Radiology in Canada, 2015 Province/Territory Physicians Phys/100k pop'n Newfoundland/Labrador 47 8.9 Prince Edward Island 9 6.1 Nova Scotia 95 10.1 New Brunswick 57 7.6 Quebec 613 7.4 Ontario 887 6.5 Manitoba 85 6.6 Saskatchewan 69 6.1 Alberta 271 6.5 British Columbia 333 7.1 Territories 0 0.0 CANADA 2466 6.9 Source: CMA Masterfile

Physicians/100,000 population in Diagnostic Radiology in Canada, 1995 to 2015 7.0 6.8 6.6 6.4 6.2 6.0 5.8 5.6 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 Source: CMA Masterfile

Diagnostic Radiologists by gender and year in Canada, 1995 to 2015 3000 2500 2000 1500 1000 500 0 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 Total Males Females Source: CMA Masterfile

Diagnostic Radiologists by age and gender in Canada, 2015 Gender Age Group Male 70% Female 30% 55-64 24% 65 and over 17% 45-54 26% 34 and under 6% 35-44 27% Source: 2015 CMA Masterfile

Diagnostic Radiologists by age and gender in Canada, 2015 65 and over 64 333 55-64 135 434 45-54 207 404 35-44 252 384 34 and Under 61 80 Female Male Source: 2015 CMA Masterfile

Main work setting of Diagnostic Radiologists in Canada, 2014 Community Hospital 34% Academic Health Sciences Centre 28% Private Office/Clinic 13% Research Unit 11% Non-AHSC Teaching Hospital 8% Community Clinic/Health-centre 2% Nursing home/ long term care facility/ seniors residence 1% Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Practice organization for Diagnostic Radiologists in Canada, 2014 1% 3% 22% Solo Practice 71% 3% Group Practice Interprofessional Practice Hospital-based Practice NR Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Hours worked per week (excluding on-call) by Diagnostic Radiologists in Canada, 2014 Activity Hours worked per week Direct patient care without teaching component 25.8 Direct patient care with teaching component 5.1 Teaching without patient care 1.4 Indirect patient care 4.9 Health facility committees 0.6 Administration 1.6 Research 0.8 Managing practice 1.7 Continued professional development 3.2 Other 0.5 TOTAL HOURS PER WEEK 45.6 Source: 2014 National Physician Survey. CFPC, CMA, Royal College

On-call duty hours spent per month by Diagnostic Radiologists in Canada, 2014 1% 2% 2% 13% 82% Up to 120 hrs/month More than 120, up to 180 hrs/month More than 180, up to 240 hrs/month More than 240 hrs/month No response Time spent on call in direct patient care = 25 hrs./month Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Remuneration for Diagnostic Radiologists in Canada Primary payment method 1 in 2013 2% 5% 9% 3% 82% Average gross clinical earnings for all medical specialists in 2013/14 (those earning at least $60,000) = $339,566 2 90% + fee-for-service 90% + salary Average percent overhead reported by all medical specialists in 2010 = 20% 3 90% + other* Blended NR * Other includes capitation, sessional, contract and other methods 1 National Physician Survey, 2013, CFPC, CMA, Royal College 2 National Physician Database, 2013/14, CIHI 3 National Physician Survey, 2010, CFPC, CMA, Royal College

Satisfaction among Diagnostic Radiologists in Canada, 2013 Balance of personal & professional commitments 5% 5% 20% 23% 34% 13% Current professional life 5% 4% 8% 13% 47% 24% NR Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied Source: 2013 National Physician Survey. CFPC, CMA, Royal College

Diagnostic Radiologists who are Royal College, CFPC or CMQ certified in Canada, 2014 99% 3% 18% 11% Royal College CFPC CMQ Outside Canada Note: Subset of those who reported a certification. Physicians could indicate more than one certification body. Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Number of Diagnostic Radiologists who retired during the THREE year period of 2012 to 2014 Males Females 98 109 1 10 2 3 15 20 < 35 35-44 45-54 55-64 65 + Total Age Group Source: CMA Masterfile year over year comparisons Note: Retired is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; those younger than 45 may include physicians who have temporarily given up their licence but return to practice at a later date.

Total and Ministry funded postgraduate MD trainees in 2014/15 Diagnostic radiology Faculty of Medicine Ministry funded Total Faculty of Medicine Ministry funded Memorial U N&L 15 15 McMaster U 32 44 Dalhousie U 20 25 UWO 23 29 U Laval 42 42 NOSM 0 0 U Sherbrooke 22 22 U Manitoba 22 23 U Montréal 48 54 U Sask 15 15 McGill U 40 71 U Alberta 25 32 U Ottawa 31 55 U Calgary 30 43 Queens U 15 15 UBC 33 77 Total U Toronto 62 150 Canada 475 712 *Includes Pediatric Radiology and Neuroradiology Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

First year and exiting postgraduate-md trainees in 2014/15 Diagnostic Radiology 100 100 30 40 7 25 50 55 57 50 Female Male 78 72 IMG GCMS 0 First year Exits from postgrad Source: 2014/15 Annual Census of Post-MD Trainees, CAPER 0 First year Postgrad exits IMG International Medical Graduates GCMS Graduates of Canadian Medical Schools

Postgraduate-MD trainees in 2014/15 Diagnostic Radiology Total of 85 first year Diagnostic Radiology trainees representing 18% of all Diagnostic Radiology trainees. Total of 475 Diagnostic Radiology trainees representing 4% of all Ministry funded trainees. Total of 155 visa trainees in Diagnostic Radiology. Total of 97 Diagnostic Radiology trainees completed postgraduate training in 2014. Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

Location of 2013 Postgraduate-MD exits in 2015 Diagnostic Radiology 30 23 23 26 15 10 9 10 0 2 2 1 1 Of the 107 exits in 2013, 80 (75%) were known to be practising in Canada Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

Stress associated with finding employment at end of residency FM resident 7% 43% 42% 8% Other spec res 6% 20% 50% 25% NR/NA Not stressful Somewhat stressful Very stressful Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College

Links to the organizations supplying information for this document National Physician Survey http://www.nationalphysiciansurvey.ca Canadian Medical Association http://www.cma.ca/pdc Association of Faculties of Medicine of Canada http://www.caper.ca/ Royal College of Physicians and Surgeons of Canada http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route College of Family Physicians of Canada http://www.cfpc.ca Canadian Institute for Health Information http://www.cihi.ca