[riahi]

It's a similar telescoping training problem in Radiology. We can train someone to have basic proficiency in interpreting a specific imaging examination in a relatively short period of time, but building the knowledge base, following up ambiguous diagnoses with pathology correlation, and seeing sufficient volume requires 5 years after internship. This doesn't even include all the knowledge we have to know for image acquisition, artifacts, and protocol design/QA. After all, you don't see what you don't know.

Yes you can look at case books and question banks and sample teaching cases, but until you are dictating the case primarily and have to decide whether to call a diagnosis which will have profound downstream treatment implications, it's a very different experience. While most specialists are comfortable with their area of imaging, I'm talking Radiologists remote reading cases for a rural location, where their report will determine if the patient is transferred and to where, with significant costs to the system and the patient if they are wrong.

I'm not sure how to "fix" it other than adopt a variant of the "commonwealth" competency-based system in Australia, where residencies have "usual" terms but if someone is competent and willing to sit the board certification exam early, they can try.