Since 2002, 100% of all first-time diagnostic radiology candidates from Jefferson Medical College passed the oral boards, conducted by the American Board of Radiology, on the first attempt. Earlier this year, the hospital’s radiology residency program also received a number one ranking, for the second year in a row. Only a handful of hospitals in the country—and only one in Philadelphia—can make this claim.

“We have among the best residence in the country,” said Levon N. Nazarian, MD, professor and vice chairman for education in the department of Radiology at Thomas Jefferson University’s Jefferson Medical College. “[But this success rate results from] a combination of factors. Part of it is that we select smart individuals, but other programs do too.

“I think what matters more is the level of training we give them. We feel that we give them extremely strong, well-rounded training in the various disciplines of radiology,” he continued. “And that everyday training we give them, over a period of 4 years, translates itself into radiologists who are very prepared to excel in their field—and also to do very well in the boards.”

Jefferson’s attending radiologists play a key role in this success story as well. Starting a few months before the boards, they will volunteer to review cases with residents after work. Hosted about three times each week, these sessions last several hours and expose the future imaging professionals to the types of cases they will be asked to assess during their oral exams.

Ultimately, Nazarian—who has been residency program director for more than a decade—said that the best way to be ready for the boards is to be working as much as possible. “In some programs, residents basically disappear before the boards to study,” he said. “During their fourth year [at Jefferson], rather than allowing them to go hide and study, we make them do every day what they are actually being tested on in oral boards: being a radiologist. We firmly believe that the more cases they see and the more clinical exposure they have, the more-effective radiologist they will be.”

And because the oral board is an intense, interactive exercise between the examiner and examinee, the best way to prepare residents for it is for the residents to actually work at the workstation, see as many cases as possible, and consult with the referring physicians, according to Nazarian.

Undoubtedly, the time and effort expended on filling the eight open resident spots has something to do with the gleaming track record. Last year, 640 hopefuls were filtered down to about 75 in-person interviews—with just eight making the cut.

Although Nazarian plays a key role in determining which students are brought in for meetings as well as offered positions, he makes sure that senior staff and existing radiology residents are actively involved. “Their input is very important. The night before the interview day, a group of our [radiology] residents will take out the applicants to dinner,” he said. This gathering performs several functions; it:

• is a hospitable welcome to candidates;
• allows applicants to meet residents and gauge compatibility; and
• gives residents a chance to weigh in on who they think will fit well in the department.

“After these dinners,” Nazarian said, “[a resident] might come up to me and say ‘I sat next to someone at dinner last night who I want to put in a good word for’—and the opposite may happen too.”

Determining if a person is a good “fit” for the department is more difficult than simply ticking off academic successes. “Our whole process is designed to select those individuals who we feel will shine in our institution and in our environment,” he said. “In radiology, you work very, very closely with your residents, so it’s absolutely mandatory that you match people with whom you will get along. In our residency, I’m very happy with the way it’s turned out—all of our residents are all very bright people, but they are also fine people and people we enjoy working with—and that’s very important.”