title: Diagnostic Radiology Resident and Fellow Workloads: A 12-Year Longitudinal Trend Analysis Using National Medicare Aggregate Claims Data.
abstract: OBJECTIVE
  The aim of this study was to evaluate changes in diagnostic radiology resident and fellow workloads in recent years.
  
  
  METHODS
  Berenson-Eggers Type of Service categorization was applied to Medicare Part B Physician/Supplier Procedure Summary Master Files to identify total and resident-specific claims for radiologist imaging services between 1998 and 2010. Data were extracted and subgroup analytics performed by modality. Volumes were annually normalized for active diagnostic radiology trainees.
  
  
  RESULTS
  From 1998 to 2010, Medicare claims for imaging services rendered by radiologists increased from 78,901,255 to 105,252,599 (+33.4%). Service volumes increased across all modalities: for radiography from 55,661,683 to 59,654,659 (+7.2%), for mammography from 5,780,624 to 6,570,673 (+13.7%), for ultrasound from 5,851,864 to 9,853,459 (+68.4%), for CT from 9,351,780 to 22,527,488 (+140.9%), and for MR from 2,255,304 to 6,646,320 (+194.7%). Total trainee services nationally increased 3 times as rapidly. On an average per trainee basis, however, the average number of diagnostic services rendered annually to Medicare Part B beneficiaries increased from 499 to 629 (+26.1%). By modality, this represents an average change from 333 to 306 examinations (-8.1%) for radiography, from 20 to 18 (-7.4%) for mammography, from 37 to 56 (+49.7%) for ultrasound, from 88 to 202 (+129.1%) for CT, and from 20 to 47 (+132.0%) for MRI.
  
  
  CONCLUSIONS
  Between 1998 and 2010, the number of imaging examinations interpreted by diagnostic radiology residents and fellows on Medicare beneficiaries increased on average by 26% per trainee, with growth largely accounted for by disproportionate increases in more complex services (CT and MRI).
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. Electronic address: falgun.chokshi@emory.edu.
authors.forename: Falgun H
authors.initials: FH
authors.lastname: Chokshi
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
authors.forename: Danny R
authors.initials: DR
authors.lastname: Hughes
authors.affiliation: Department of Biology, University of Central Arkansas, Conway, Arkansas.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wang
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Mullins
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Hawkins
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; Harvey L. Neiman Health Policy Institute, Reston, Virginia.
authors.forename: Richard
authors.initials: R
authors.lastname: Duszak
mesh_terms: D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D006801:Humans; D007396:Internship and Residency; D006278:Medicare / Q000706:statistics & numerical data*; D011871:Radiology / Q000193:education*; D014481:United States; D016526:Workload / Q000706:statistics & numerical data*
keywords: Medicare; Resident education; fellow education; workloads