AJR Podcasts

The radiologist shortage is real, and international medical graduates (IMGs) are already helping solve it. Sohrab Afshari Mirak, MD, speaks with cohosts Surbhi Raichandani, MD, and Sherry Wang, MBBS, about his path from Tehran to UCLA, the American Board of Radiology Alternate Pathway, visa hurdles, and what IMGs bring to patient care. Listen to their discussion in episode 3 of Difficult Conversations, an AJR Podcast Series.
*Key Takeaways
Beyond the Step Score: Residency programs should not filter IMG applicants based on USMLE scores or graduation gaps; letters of recommendation and other application components offer additional important information.
 

The ABR Alternate Pathway: Recent changes by the American Board of Radiology now allow internationally trained radiologists to complete their four required fellowship years non-consecutively within an eight-year window, significantly reducing a source of uncertainty. 
 

Clinical Diversity: IMGs bring unique proficiencies and skill sets developed in healthcare systems with workflows that differ from in the United States.


*Chapters
0:00 - Welcome and Intro
0:54 - Impact of Radiologist Shortage
3:43 - Dr. Mirak's IMG Journey
6:07 - Residency Screening Pitfalls
10:02 - Letters and Observerships
12:14 - Research and Networking Tips
15:21 - ABR Alternate Pathway
18:52 - Visa Choices and Waivers
25:44 - Cultural Support for IMGs
28:38 - Global Models and IMG Value
35:56 - One Policy Change 
38:05 - Closing Thoughts
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Good research questions may be hiding in everyday clinical work. Marco Francone, MD, PhD, and Daniel Pinto dos Santos, MD, speak with host Amit Gupta, MD, about transforming clinical intuition, recurring gaps, and diagnostic challenges into focused, testable, and clinically impactful research. Listen to their discussion in episode 2 of The Early-Career Researcher's Playbook, an AJR Podcast Series.
https://www.ajronline.org/doi/10.2214/AJR.26.35769
*Key Takeaways
Questioning the Routine: Meaningful research often begins by simply asking "why" established practices exist. For example, questioning the necessity of a non-contrast series prior to contrast media administration when looking for abdominal hemorrhage may lead to a publishable study.
 

The Prospective Shift: Retrospective research may be limited by biased intuitions and imperfect hypotheses. The specialty should move toward prospective models, carefully considering the clinical impact and cost-effectiveness of potential interventions.
 

The "Tool-First" Trap: Pushed by a publish-or-perish academic culture, researchers may make the mistake of starting with an AI model or radiomics pipeline and then searching for a problem to which to apply it. True clinical impact more likely comes with starting with the patient problem and finding the appropriate method to solve it.
 

Combating Confirmation Bias: When researchers firmly believe their own clinical intuition, they risk designing studies solely to confirm their preconceived notions. To maintain scientific credibility, you should assign a colleague the specific role of opposing your views to actively try and prove your hypothesis wrong. 


*Chapters
0:00 - Introduction
2:07 - What Clinical Intuition Means
6:47 - Daniel's Routine to Research
9:23 - Ideas Hiding in Workflow
11:32 - From Observation to Study Plan
14:28 - Marco's Prospective CT Example
18:26 - Avoiding Confirmation Bias
23:20 - AI Tool First Trap
29:53 - Quick Fire Takeaways
33:34 - Final Advice and Closing
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*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

How fast can a knee MRI examination be performed? Zahra F. Rahmatullah, MBBS, discussed the article by Leonhardt et al. exploring a deep-learning pipeline for achieving 7-minute knee MRI.
Full article: Arthroscopy-Validated Diagnostic Performance of a Deep Learning Reconstruction Pipeline for Rapid 7-Minute Five-Sequence 3-T Knee MRI
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In-stent restenosis presents a challenge on coronary CTA. Bryce Saba, MD, discusses the multicenter study by Xu et al. exploring a super-resolution deep-learning reconstruction method for stent evaluation.
Full article: Comparison of Super-Resolution Deep-Learning Reconstruction and Hybrid Iterative Reconstruction for Coronary Stent Assessment on CTA: A Prospective Multicenter Study 
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Could you handle the high-stakes pressure of working with professional athletes? Chris Beaulieu, MD, PhD, speaks with co-hosts Lindsey Negrete, MD and Amy Maduram, MD about the medical, legal, and communication challenges involved when dealing with a professional sports franchise. Listen to their discussion in episode 2 of Extreme Radiology, an AJR Podcast Series. 
https://www.ajronline.org/doi/10.2214/AJR.26.35724
*Key Takeaways
The Monday Morning Rush: While game-day X-rays are typically read by team orthopedists at the stadium, the radiologist's critical role begins on Monday morning with reserved MRI slots to accurately stage and grade joint injuries. 
Call it Tight, But Call it Right: Radiologists should avoid overcalling minor, non-acute incidental findings, such as mild degenerative changes, that could needlessly trigger panic.  
Controlling the Narrative: Direct communication with players, coaches, or sports agents is highly discouraged due to the risk of misinterpretation. Radiologists maintain a strict reporting chain directly to the head athletic trainer and team orthopedic surgeon.  
Astronomical Liability: The malpractice risk in pro sports imaging operates on a vastly different scale, with potential liability reaching hundreds of millions of dollars to cover an athlete's lost career wages.  
Second Opinions: Because most sports injuries are non-surgical and imaging serves as the gold standard, agents frequently demand multiple opinions. 
*Chapters
0:00 - Welcome
4:15 - Game Day Imaging Setup
5:34 - Monday Morning MRI Rush
7:48 - Stadium PACS And Teamwork
9:47 - Communication With Players
11:30 - Pressure And Liability
13:50 - Reporting Nuance And Contracts
19:53 - Ultrasound-Guided Interventions
22:18 - Call It Tight. Call It Right.
27:51 - Monday Morning Quarterback Game
40:06 - Closing
Follow AJR on Social Media
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YouTube: https://www.youtube.com/channel/UCfFAYezkLMxJGMgIJLN0Dpg
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Threads: https://www.threads.com/@ajr_radiology
*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.