Evolving Radiology Trainee Neuroimaging Workloads: A National Medicare Claims-based Analysis

Area of Science:

• Neuroradiology workload analysis
• Radiology trainee education
• Healthcare workforce trends

Background:

• Radiology training programs prepare residents for clinical practice, but the evolving relationship between trainee workload and national demand for neuroradiology services remains unclear.
• Understanding these trends is crucial for aligning training with future workforce needs.

Purpose of the Study:

• To assess the changing neuroimaging workloads of radiology trainees nationwide.
• To analyze the relationship between trainee workload and national neuroimaging utilization in Medicare beneficiaries.

Main Methods:

• Utilized aggregate Medicare claims data from 2002-2018 for brain, head and neck, and spine neuroimaging (CT and MR).
• Calculated population utilization rates and work relative value units (wRVUs) for neuroradiology services.
• Identified services rendered by trainees using claims modifiers and national trainee enrollment data.
• Determined mean annual per-trainee wRVUs for neuroimaging.

Main Results:

• Total Medicare neuroimaging claims increased by 86.1% for all radiologists and 162.5% for trainees between 2002 and 2018.
• The proportion of neuroimaging wRVUs performed by trainees rose from 3.8% to 5.6%.
• Mean annual neuroimaging wRVUs per trainee increased by 174.9%, with the greatest rise in spine CT (+394.2%).

Conclusions:

• Radiology trainee neuroimaging workloads have increased disproportionately compared to the overall growth in neuroimaging utilization among Medicare beneficiaries.
• These findings suggest a significant shift in trainee responsibilities within neuroradiology.