The ACR recognizes that fostering leadership skills is critical to the delivery and advancement of high-quality healthcare. In 2012, the ACR launched the Radiology Leadership Institute® (RLI) — the specialty’s first program dedicated to professional development and leadership training for radiologists.

The ACR knows that to survive and thrive, every radiologist needs to fill gaps in non-interpretive skills. That’s where the RLI comes in. Built by radiologists for radiologists, the RLI helps boost business skills through valuable training and customized professional development opportunities.

In the third of a four-part series commemorating the RLI’s 10-year anniversary, the Bulletin connected with some of the RLI’s world-class faculty to learn how they design RLI programs to help radiologists navigate leadership at all career stages. A key commitment for the RLI is to continuously enhance its programming to keep pace with changing times, and the organization knows that collaboration is key to creating a successful course. To that end, RLI faculty engage with and solicit feedback from participants and other stakeholders to ensure that the program delivers on its goals. This process ensures that the RLI is able to offer the type of customized, essential, high-impact content that keeps ACR members coming back.

Fostering Future Leaders

Young physicians enter the workforce armed with comprehensive clinical and interpretive skills but often lack the valuable business skills that are necessary to thrive in today’s healthcare settings. Although programming is strongly guided by RLI’s knowledgeable faculty, the RLI knew it was also important to represent learner voices, especially early-career learners, regarding the unique career challenges that they felt residency did not adequately prepare them for — as well as course formats that would be most attractive for them. The RLI used feedback from over 200 residents to help design a few of the resident-focused programs that empower these new radiologists and equip them with the knowledge and tools they need to excel in their careers.

The RLI created the Leadership Essentials program to fit into the busy schedules of residents and fellows and give them the foundational, non-clinical business skills they need. Based on the survey feedback, as well as input from a working group of residency program directors, the inaugural program co-chairs, Richard Duszak Jr., MD, FACR, chair of the Commission on Leadership & Practice Development, and C. Matthew Hawkins, MD, director of pediatric vascular IR at Children’s Healthcare of Atlanta, developed a program to provide training for residents and fellows in the non-clinical and leadership skills most relevant to early-career success.

“Our learner audience is very different from the typical private-practice radiologist,” Duszak says. “Residency is hectic, so we specifically and deliberately designed the course to accommodate residents’ schedules and help prepare them for practice.”

In 2021, Ann K. Jay, MD, vice chair of education and program director of diagnostic radiology residency at MedStar Georgetown University Hospital, and Ryan B. Peterson, MD, assistant professor and associate program director of diagnostic radiology residency at Emory University School of Medicine, assumed the roles of co-chairs and expanded the Leadership Essentials program to focus on content for both residents and early-career radiologists:

• Leadership Essentials 101: Skills for Residency and Beyond. This curriculum focuses on all years of residency and offers content that can be put into practice during residency and in the first years of a resident’s career. Topics include rookie leadership, communication skills, and personal finance.
• Leadership Essentials 201: Preparing for Practice. New in 2022 and geared for R3s or later, this course offers content that will be helpful in the first few years of a radiologist’s career. Topics include basics of radiology business, tips to building and growing your practice, and the value of being a mentor yourself.

The two Leadership Essentials curricula will be offered on a rotating basis, with Leadership Essentials 201 launching in fall 2022.

"Residency is hectic, so we specifically and deliberately designed the course to accommodate residents' schedules and help prepare them for practice."

Preparing to Enter the Job Market

Radiology residents report that finding and landing a job that’s right for them is an area where they’d like more support. Informed by the initial resident survey results, co-chairs Frank J. Lexa, MD, MBA, FACR, who serves as RLI chief medical offer, and Jennifer E. Nathan, MD, RLI board member, developed the Kickstart Your Career workshop, a one-day course that provides the content that residents said they needed to land that first job, but that wasn’t being addressed in their residency.

The Kickstart program provides essential advice on topics such as interviewing skills, evaluating job offers, communicating with challenging personalities, and understanding the differences between employment opportunities in academia versus private practice. “Something like this never existed when I was a new radiologist looking for my first job,” Nathan says. “I wish it had because I would have learned so much and been more prepared.”

Nicholas Ferguson, MD, a radiology resident in Loma Linda, California, agrees. “As a relatively fresh fourth-year resident in my early thirties, I began to think about getting a job,” he says. “Surprisingly, no one had ever really formally taught me this type of skill — after all, it’s not on the boards. Then I found out about the Kickstart Your Career workshop, looked at the speakers and subjects, and decided it would be worth the time. It was definitely worth every second I spent on it.”

Mentorship also remains a highly requested and important topic. While the Leadership Essentials program aims to highlight why and how residents can go about finding a mentor and getting the most out of a mentoring relationship, Kickstart actually provides an opportunity for residents to work with a mentor.

The RLI added the Transition Mentorship Program in 2021, allowing attendees of the Kickstart program to be matched with a mentor who has experience in their area of interest to help with the transition from residency into fellowship or a first radiology job. Nathan echoed the survey feedback and strongly believes mentors are an invaluable resource for young radiologists. “You can get all the information and try to figure things out for yourself, but I think having that person who’s a little further along in their career to help guide you, that’s probably the most critical thing,” she says.

Confronting New Challenges

As physicians gain experience, they often seek out — and land — leadership roles. New and aspiring leaders wish to be as effective as possible in their new roles, but often require a specific skillset to be successful. The RLI recognized this skills gap, and asked Geoffrey D. Rubin, MD, MBA, FACR, RLI board member, to create a program designed to give these aspiring and new leaders the skills, tools, and language to be effective in these new roles and environments.

“As radiologists begin to take on leadership roles, many point to key moments that reveal how much more there is to learn about their organization and how it functions,” Rubin says. His own experience stepping into a leadership role directly informed the curriculum, which emphasizes the importance of understanding organizational structures. “I showed up to the first meeting like a fish out of water — there was a huge table with 30–40 people, and after 16 years at this medical center, I didn’t know more than three of them,” Rubin recalls. “They would pass out papers to everybody, things like financial statements, strategic plans, organizational design plans, and it was like another language to me.”

Rubin eventually accumulated the set of competencies that allowed him to become a strong leader. Yet he always wished that he had been more prepared to enter that environment and be more effective from the start.

The Maximize Your Influence and Impact program is cohort-based and structured into the three topic areas that Rubin and his co-educators found to be most relevant in their own leadership experience — managing the hospital boardroom, stewarding the radiology department, and influencing change at the hospital level. Participants learn the business skills necessary to run a radiology practice or department with confidence and gain soft skills such as interpersonal relationship-building, team support, and conflict management.

When recruiting faculty for the Maximize course, Rubin strives to find nationally recognized and experienced leaders that bring a diverse perspective. “It’s not just a matter of finding academic departments chairs to lecture — we have teachers from community practice, teachers that run health systems and who have run radiology departments, we have gender and racial diversity wherever possible,” Rubin says.

The RLI takes an in-depth approach to addressing the spectrum of valuable leadership skills, and uses learner feedback to guide decision-making, including appointing new faculty members. Rasu B. Shrestha, MD, MBA, chief strategy and transformation officer and executive vice president of Atrium Health, recently joined RLI as an instructor in the Maximize course. “Rasu personifies an outside-of-the-box approach to leveraging radiology expertise toward healthcare leadership,” Rubin says. “He embodies the best qualities of a leader — humanistic, creative, strategic, and team-oriented. I know our cohort of radiology leaders will find his approaches and thought processes to be eye-opening and empowering.”

Tackling Complex Demands

The evolving demands of healthcare directly affect practice environments, and mid-career and experienced radiologists require timely educational offerings to help navigate complex management settings. That’s where the RLI Summit comes in.

Designed in collaboration with business school experts, the Summit helps radiologists at all career stages gain new insight into where radiology is headed and receive focused training that will help guide how their practices adapt in the future. Since 2014, the RLI Summit has been held at Babson College, one of the nation’s top entrepreneurial business schools.

Alexander M. Norbash, MD, MS, FACR, RLI Summit co-chair, emphasizes the organization’s desire to partner with a business school that would be responsive and nimble. “We were thinking if adaptability is an important character trait — if you’re supposed to react to the market around you by giving patients and insurance companies what they need, then you want a partner that understands the value of responsiveness,” Norbash says. This collaborative approach allows busy physicians to gain crucial business and management skills without the commitment and expense of pursuing a business degree.

At the Summit, subject matter experts apply a radiology lens to the latest business models and tools to help attendees learn how to improve both patient care and the practice of radiology. The sessions are created to give radiologists a deeper understanding of some of the biggest issues facing the specialty and offer insights and solutions to transform challenges into opportunities.

Norbash has found that the case studies and discussions at the RLI Summit resonate with radiologists at all levels. “We bring in challenges and problems that other leaders have faced,” he says. “Whether it’s diminishing margins, the corporatization of radiology as an opportunity or challenge, teleradiology, or a hospital giving up contracts for bids — we have individuals who have special expertise at drawing these very detailed cases.”

Transforming Leadership Education Alongside Healthcare Demands

Over the last decade, more than 9,000 radiologists from across the U.S. have participated in numerous RLI programs, gaining the essential, non-clinical skills to survive and thrive in today’s complex and ever-changing healthcare landscape.

The RLI is staying ahead of those changes by bringing in radiology and business experts at the forefront of healthcare. Engaging with ACR members and soliciting participant feedback is also critical to creating valuable, tailored content. This engagement, combined with the strength and expertise of its world-class faculty, sets the RLI apart from other leadership programs. Many radiologists come back year after year for additional leadership and business skills training as their roles change and the RLI programs expand and evolve.

With programming for radiologists who are leading change at all levels, the RLI can help every radiologist advance their careers and master the challenges ahead. “Radiology leaders aren’t created overnight,” Nathan says. “Leadership is a marathon, not a sprint.”