From Education to Employment: Closing Radiology’s Workforce Gap (An Interview with The Imaging Wire)

[music] Hello and welcome to the Imaging Wire Show. My name is Brian Casey. I'm managing editor of The Imaging Wire. Got a great episode for you today. We're'll be uh discussing new tools for closing radiologyy's workforce gap. And our guest is Daniel Arnold. He is president and co-founder of online education firm Medality. Daniel, thanks for being with us again uh today. Can you tell us a little bit about yourself and your role at Medality? >> Yeah, great to be here. Thanks, Brian. So, you know, we started Medality gosh, six, seven years ago now with uh the goal to build the the best online training platform for radiologists and we continue to make amazing strides. Most of us know Medality for our amazing online courses. We teach everything from the most basic how to interpret a chest X-ray through to the most advanced imaging courses on things like cardiac CT, stroke CT profusion, PET PSMA, prostate MRI and more. And what makes our learning platform unique and differentiated in the market is is we bring together the world's greatest radiologists, hundreds of of academic radiologists teaching on our platform, teaching in a simulationbased training environment. So you can actually review um real world cases and then get amazing explanations in just two to three minutes uh right there at the workstation on your iPad or on your phone. Um and we've grown tremendously. We we work with now um most of the academic training programs across the US and across the globe um as well as many of the largest uh radiology practices. And so uh it's it's been an amazing journey and and uh great to be here today. >> Awesome. And you guys have had some some pretty big news at Modality since the last time we talked. Can you share a little bit about that? >> Yeah, absolutely. So, um, last year at the start of the year, we actually, uh, were acquired by a medical education, a larger medical education platform called Truelearn. And this partnership has been amazing. Um the truelearn is the uh an advanced online learning platform serving a broad variety of medical learners all the way from um med students through into several residencies like surgery and anesthesia and then out into the professional CME world. And what makes their platform unique is um they help learners prepare for high stakes lensure exams. So think board exams, USMLE exams, DO complex exams. Um so getting that license and then once you get licensed um there's a whole robust set of data and analytics supporting your ability to um confidently prepare for and pass those exams and then once you are licensed continuing to stay up to date in your field through continuing education through products like Medality and others. Um, I'll I'll I was drawn to the opportunity to partner with Truelearn for a few reasons which we which we'll get into here in a minute. Um, and uh it's been an amazing partnership and and the team has really thrived working together over the last uh almost year and a half. >> Awesome. Well, sounds like a great fit. Um, so we're going to be talking about the workforce shortage in radiology right now. And in our last conversation, we talked a lot about it. um what are you seeing now that's changed since then and and what's become more urgent? >> Yeah, so the workforce shortage um is as acute as it's ever been. This past year um you and I were at Arsena together and have you ever seen recruiters row as as long and and [clears throat] robust uh as it was? No, it's it's yeah, it's it's a the recruiting is is a challenge. Um >> it's it's a it's a real challenge. Demand for radiology services continue to grow and it it continues to be really hard to to fill um and create supply of of of radiologists and and uh you [snorts] know so we've been asking ourselves what role we can play in addressing the workforce shortage and we do this across a number of fronts. One is through learning. Um, and so, you know, one of the things that ends up being required is reading outside of your core competency. And so, you might be an MSK trained radiologist, but the practice is seeing growth in new areas. And you're going to have to step up and learn how to do that. And you can learn that on the job through what we call our fellowship certificate program. So, you can learn something like prostate MRI or cardiac CT or PEP PSMA as those volumes start to grow and your practice needs help on those studies. But um you know we also one of the one of the things that you know as part of True Learn more broadly we've been thinking about how can we address the workforce shortage all the way from helping folks get licensed those earliest days through to then finding the right role for that person and then hopefully retaining that person through and enabling them to be you know practicing at the top of their license throughout their career. And so um we at Truelearn actually launch are launching um maybe by the time this comes out it's sometime here in midappril I'm not sure when the interview comes out we're launching modality's very first job board and oh um that job board is going to help connect radiology practices roles to what we believe is the most trusted radiology network um you know out there modality today uh serves over 70% of trainees and that number continues to grow and so you know before long we believe every radiology trainee um will be using modality during their training regime and then they're coming to us and asking hey where should I work um and they're asking that question a number of ways you know one thing is finding a job you know who everyone's hiring so that's not hard to figure out but what are the specifics of the job how can I find um a practice where I want to work doing the type of work that I want to do in my specialty maybe that fits my life parameters, those types of things. And so there's finding the job, but then there's also so much more that we can help radiologists um and support them in their work first journey. So one thing is, you know, how should I think about finding a job? Um what kind of practice is right for me? Do I want to work in private or academic? How do I think about different compensation models? How do I think about, you know, what's the right fit for me? Um and my personality and my specialty and more. And so, um, we're going to be supporting the job board with a series of educational initiatives, which is where Medality really shines to help folks learn about how to approach their career journey. Um, and then there's so much more we can do, but I'll pause there because we're really excited about it. >> Yeah. Do you feel like, Daniel, do you feel like there's a breakdown between trained radiologists and the available opportunities out there for them? >> You know, I think there's a there's a lot of opportunities for radiologists. um you know today as a radiologist it's not necessarily a challenge to find uh you know to get hired. The the what makes it a challenge is how do you find the right job for you? Um and what we are hearing more and more is there's a lot of turnover, higher turnover than ever because people aren't finding the job that's right for them. Um and they're finding that, you know, they're having a hard time figuring out, hey, I want to work in a private practice. Maybe I want to work um nights, I want to work shift work, I want to work swing shift. And so the preferences, the wide range of preferences has really changed because of teleradiology. And so what we're going to be helping folks do, which does not exist in a really good way today is help through tools and technology better see the wide array of different types of jobs that might be a fit for you so that you can better match in and cut through the noise. You know, one of the things that we hear is from some of our competitor job boards, there's so much information out there, it can be really, really hard to filter through, sift through, and understand, you know, what might be the right place for me. And so, we think we can bring both technology to bear to the to the candidate side. Um, but then also for employers, they want to connect with engaged, high-erforming radiology trainees. And we believe that we have the most differentiated network of high performance radiology trainees because those radiology trainees that are using modality for their ongoing learning um are the types of trainees that you want working in your practice, those that are self-motivated to continue to learn and our jobs will be placed throughout our network of courses where radiologists are learning every day. >> Awesome. Let's Daniel, let's let's double back to the the training issue. Do you think there's a disconnect between training and workforce demand? >> You know, it's a good question. Um, we added a few radiology slots this year, um, but we're not adding them fast enough. Uh, you know, if you ask me, I think there's a lot we could do to add more slots, um, here in the US. Um, and you know, I've I would encourage private groups to partner with academia to find ways to fund uh, more residency slots. uh especially because so much training, you know, one of the one of the core barriers that you'd hear cited about why you can't add more training slots is that there's not enough teachers. Well, a lot of teaching can be done through other means. And so, I think for, you know, questioning, can we get creative um both from a funding model and from an education model in order to expand the number of radiology slots um could be really impactful. Um but uh the other thing that you can you know look to is is international medical grads. Uh I think that that's harder um than it sounds but there are some countries that are doing really well in this. um modality actually partners with many practices in Australia to support the assessment of international medical graduates and then based on their their performance on various assessments close training gaps so that they can actually get pre-approved and then if they have some learning gaps close those gaps through modality um so that they can then go practice in their local markets. >> Yeah. Let's let's talk a little bit more about this idea of training gaps. Um, and my understanding is that this is is is a gap between what they're trained for and what they need to do once they join a practice. Can you talk about what modality does to kind of give them exposure to a full range of clinical work to make them um, you know, more valuable to the practice they join? >> Yeah. One of the biggest um challenges we hear from radiologists when they first join a practice is that they didn't have exposure to the type of volume that they're going to be seeing in their clinical practice. And so typically, you know, most radiologists have a really strong general radiology background, really comfortable doing hospital um general radiology work and call and the like. Um but oftentimes practices don't have exposure to some of the more advanced imaging areas that have become commonplace. So an example might be mski. Um if you are in residency, chances are most academic residencies just don't get that much MRI volume. And so um mskmi volume for that matter. Most of that's usually done in the private practice setting. And so then if you go into to a practice that has a strong outpatient MRI business that's doing a lot of mski, you're going to be pretty unprepared um for those volumes. And so you can supplement that learning through modality which has the largest collection of MSKMRI courses anywhere. That example for MSKMRI is also true for many neuro specialties. So in a lot of places for example in residency some of the neuromi residents might not be allowed to read it at all. It always goes to the fellows. And so when you go out to a community practice they want you to have more exposure than you have. And so we believe that we can really help programs complement, supplement um and augment any gaps that they have from a volume perspective by um pairing that up for their learners. >> Awesome. Now let's we talked about the job board uh that you guys are launching. Um let's talk about another new product that you just recently launched called uh SmartBank. And can you tell us about SmartBank and and what the core problem is that it was uh developed to solve? >> Yeah, and this is why I wanted to lead off Brian by talking about the acquisition from Truelearn. So, you know, one of the fears that you have anytime you sell a business or partner, you know, merge a business is that the innovation's going to go away. And you know, I'm so excited today to announce the smart bank, which we launched um at RCNA last year. So within one year, less than a year of our acquisition, we developed an entirely new product category that is going to supercharge modalities growth. And SmartBank is a tool that combines uh questions. So we now have over 800 soon to be a thousand board level questions with a full simulation viewer that mimics the ABR board exam format mapped to the ABR curriculum. And through that you get detailed explanations. So not just did I get it right, did I get it wrong, but why are you why'd you get it right? What's wrong with the other answer choices? How um and then a robust set of analytics. analytics like, hey, you got this right. Um, you got this wrong. 80% of people are getting this question right. So, you probably should have gotten it right. Okay. Where's the gap in my learning? Okay. Well, we have thousands of hours of training on modality. We can point you to learning that can close that learning fundamental learning gap. We also have tools like um analytics that can show you how you're performing within your cohort of residents. So, am I, you know, performing at the top, meaning I'm likely in good shape, or am I performing near the bottom? And by the way, you might be performing near the top, but maybe you're performing near the top in seven of eight categories, but in breast imaging, your knowledge isn't very strong. And so here's the areas where you're really struggling. And let me dive into that. Then all of these tools support learning at scale for residency programs. So if you're a program director and you have a 100 residents, how do I know how my residents are performing? Are they confident? Are they confident across all subsp specialty areas? What's my pass fail rate likely to be on the upcoming core exam? And what interventions can I take? And so this robust platform would have taken us 5 years candidly to build on our own. But thanks to this partnership with Truler and we were able to develop it in 10 months. And uh we just came back from the association of American um or of association of academic radiologists, the largest meeting of academic radiology program directors, program chairs, program coordinators, and they are fired up about this product. >> Awesome. how how is it different from traditional uh question banks or or or board prep tools that have you know kind of been out there? >> So you know I think there's uh two call it main competitors in this space who know who they are. Um and they're both you know just a little long in the tooth. Uh the main complaints that we hear are across editorial and technology. So on the editorial side, a lot of the questions just are not relevant to the exam, have not been updated frequently enough. And so, you know, they might have been good 10 or 15 years ago, but they're just not where the the the quality needs to be. Maybe they don't have images. Almost every single exam question on the ABR has images. And so if you're presenting learners with non-image-based questions, that's just not relevant to them. So that's um you know, one is our editorial advantage. And we will continue to add new questions every year. We're adding another 50% of new questions this year and into the future. And so you can know that our board will stay relevant and stay upto-date. And then number two is on the technology side because of our promise to be a simulationbased training platform. The exam is completely completely simulates what you can expect on the DXIT and ABR core exams. And so you know the learners are going to be really really prepared using our technology. And then finally the analytics um the analytics p tool suite that we offer just doesn't exist anywhere on the market. And so um learners and program uh leadership alike are flying blind and don't know how their folks are are going to perform on these exams giving a lot of stress and anxiety as well as lower pass rates than they could they should be expecting. >> That's a that's a great point. Do do you feel like repeated targeted practice on on on something like a board exam like this does that translate into into better clinical performance when these radiologists get out into the workforce? >> Absolutely. So um and we we actually use tool called space repetition. It's not just about how many questions that you do but how many questions you do over time and how do those difficulties align. And so we used lots of technology to make sure, hey, Brian's been getting these types of questions wrong. Let's try to make sure that we hit him with a few of those interspersed um over the next few months so that his learning comes up. And there's all sorts of data and research and that we've published as Truelearn about this uh about these tools showing superior learning outcomes. That's the same as radiology. You know, this is the the practice of doing radiology. It's seeing lots of cases. um and you know challenging yourself and then understanding if you got them right or wrong and and adjusting. And so we believe that these tools will translate really really well. And by the way um this smart bank that I just described while really helpful for trainees is also really helpful for radiologists out in practice. So we also have this question bank available for CME um and so people can go on to modality and in addition to their video-based learning do case-based learning which was the number one request that we had from our um professional learners. >> What do what are you seeing from some of the early users of SmartBank about the approach and how how do they how are they reacting to it? >> They love it and they're begging their program leaders to buy it for them. Um and I'm confident that they will uh here soon. >> Awesome. And is smart bank about you know is the main goal of that just to pass an exam or is it about something like a little bit bigger than that? >> It's definitely bigger than that. So you know the exam the core exam is you know in your third year and that's really high stakes related to your lensure. Um but we actually work with groups to use the smart bank throughout their entire learning journey. And so we'll actually carve out the questions to show you here's what's appropriate for a first year trainee. are they getting the the learning that they need and how do we reinforce that learning through um whether it be the daily noon conference that they're receiving or the structured learning that they're doing at a workstation with attendings and identify those gaps earlier. If you can identifi you know oftentimes what can happen is mistakes in your first year where you miss some fundamental knowledge are what's then making it really really hard for you to understand things in your second and third year when the when the concepts are getting more advanced. And so ideally we can find those things early on and um remediate those through um continued education whether that be through medality or through the the clinical uh education experience. >> Perfect. Do you do you see connection between smart bank and the job board that modality is launching in terms of like how they work together as part of like a larger employment ecosystem. >> Yeah. Uh I mean at the end of the day we are here to support clinicians through their entire journey when it starts from getting into med school. Um a lot of residents now are actually using Truelearn product to prepare and pass their exams to prepare for um getting licensed for med school. Then once you get licensed for med school and I get into radiology residency, how do I become the best radiologist I can be confident in clinically through that exposure to online learning? What kind of radiologist do I want to be? Do I want to be an MSK radiologist? Do I want to be a nur radiologist? Maybe I want to be a multispeist and practice across a number of areas. We believe that exposure to amazing radiologist modality and amazing cases can help them um as they start to think about what it is that they really love in radiology. From there then okay what job do I want and how do I think about that now I find my job okay well I've joined a new practice shoot I got got to get licensed and credentialed well we play a role in that too um how many states are you credentialed in you just you just credentialed in Texas or you going to actually be doing terra radiology maybe you've got to hold um licenses across six or more states or 10 or 50 in some cases am I going to be reading mimography how do I maintain my mimography uh or cardiac credentials we can bring all that into one place and then as you kind of continue to add skills and and grow. Uh we hope you continue to do that through Medidality through the lifetime of your career. >> Yeah. So it sounds like you're at Medality is creating kind of a fully connected, you know, radiology training to practice pipeline. >> You got it. >> Awesome. That's great vision. Um well Daniel, do you do you have optimism about the workforce shortage and you know using a lot of these tools that we've been talking about today? Do you think we're going to be able to solve some of the challenge of this this this disconnect between how many radiologists there are and and and imaging volume going up every year? >> Everyone is playing a role in in addressing the workforce shortage. And uh you know I I just came from the AR where I'm seeing a lot of open-mindedness whether it be um how can we use technology, how can we use um how can we train people, how can we train different people. Um there's a lot there's going to be a lot to address these concerns, but you know I'm pretty confident 5 to 10 years from now it's going to look a lot different. Um and so the best thing radiologists can do is continue to learn. The field is changing. the field is changing fast. Um, and Midality is going to be there to support those radiologists as that field changes to stay upto-date and practice at the top of their game. >> If there was one thing that you could change about the way we train radiologists and place them in jobs today, what would it be? >> Oh, um, you know, I think my my my crystal ball would be to better connect radiologists. the fields become a bit isolated and so I think sometimes people aren't getting the best advice um that they could be about what will make them happy and at the end of the day radiology is an amazing profession and our radiologist should be really happy and enjoying the work that they're doing and I think some of the best ways to do that is is coming from meeting people whether it's going to a conference engaging with radiologists online getting to know radiologists in some of the local practices years before you go work there and understand like hey what's a day in your Uh, right now I think there's a little bit of a focus on money per click. I want to make the most I can. Um, and I get that pressure, but sometimes that doesn't actually lead to the best happiness and the best fulfillment in in their job as as you know, Brian. Um, as somebody who, you know, has has carved out an amazing and interesting career. There's more to life than that. Um, and so I just hope some of that can break through into the next generation of radiologists. They can really find jobs and people they like working with. Awesome. That's great advice. Uh well, uh Daniel Arnold of Medality, it's been great talking to you again. Thanks so much for uh briefing us on some of the developments at the company. >> Awesome. Thanks, Brian. Keep up the great work. >> Thank you. Signing off for the Imaging Wire. My name is Brian Casey. [music] [music] >> [music]