Didactic lectures, presented to nearly all residents once or twice a day, come in two basic flavors: case-based, where residents take cases, or more formal didactic-style lecturing. Some programs may be modifying their curricula to help students prepare for the core exam, he said. Residents should incorporate physics into their daily readouts at the workstation, and maybe even do a dedicated physics review before the core exam.
The RSNA physics modules are an excellent learning tool for physics, he said. Safety issues, including radiation biology and safety, fluoroscopy geometry and doses, modifications in CT protocols and how they affect dose, and artifacts and how to eliminate them, are the "most high-yield, clinically applicable topics in physics," from the perspective of exam prep, Stephens said. Considering the complexity of the topic, some residents find a dedicated physics review course worth the time and money.
In any case, physics study should be continuous throughout a residency. After all, it's the single largest section on the core exam, and physics questions count in multiple categories, Stephens said. Generally, textbooks offer more-detailed ways to drill down on a topic, Stephens said in his talk. He said he found them most useful for doing targeted review of specific topics rather than for cover-to-cover reading, but user preference should prevail.
The ACR website is probably the best resource for safety, as it includes contrast, radiation, and MR safety -- "all those areas are covered in a fairly readable manner, particularly the manual on contrast," he said. It covers a lot of practical topics that arise in clinical practice, including what to do if a breastfeeding patient needs a contrast exam and what you need to know about contrast reactions, along with other topics that arise infrequently. RadioGraphics review articles were excellent as well, particularly with regard to artifacts.
And Stephens said he did a dedicated physics review course about four weeks before the exam, which allowed enough time before the test to go over areas where he felt he still needed help. A three-month dedicated review seemed to be about right to go over everything before the exam. Stephens said he dedicated about a week to each topic: MSK for one week, neuro the next, and always a day a week for physics. At the beginning of the first day of the exam, you get about 20 minutes just to learn how the software works. If you already know how to use it, you can use the extra time on the exam itself, he said.
Also recommended is the nuclear medicine quality-control review in the weeks before the exam, especially if it's not part of your regular workday. Time is not an issue during the test; you have plenty of time to take the exam. And building a knowledge base is more important than practice questions.
Resident core exams: A prep strategy that works
It is important to dedicate sufficient time to study, Stephens emphasized to AuntMinnie. RSNA McCann and Edmund Ronan Ryan.
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