As New York’s COVID-19 caseload ballooned into the thousands during the first wave of the outbreak, Jesse Chen, MD, then chief radiology resident at Staten Island University Hospital, found himself suddenly scrambling to get shifts covered while fellow residents tested positive for the coronavirus. In a recent interview with the Bulletin, Chen, past chair of the New York State Radiological Society’s RFS, discusses his experience working in a New York City hospital at the start of the pandemic, the effects of COVID-19 on radiology training, and his views on the future of the profession.

When the pandemic started in March, how did it affect your day-to-day work as a resident?

On March 13, the day after I returned from my honeymoon, a fellow resident told me he wasn’t feeling well. Within the week, two more residents reported not feeling well. In one week, we went from business as usual to skeleton crew schedules, spacing out patients in the hospital and changing schedules accordingly. We had about 50% of the residents working in-house on any given day to minimize in-person contact and the rest of the residents were at home, working on assignments, lectures, and research. The pandemic came at us fast, and we had to address clinical needs within the department and hospital more quickly than we ever anticipated.

How has COVID-19 affected radiologists in training?

There is an ongoing concern about the adequacy of training because of the lower volume of patients. Patient volume is only at about 70–80%, probably due to people leaving New York City, not wanting to travel into the city, and hesitating to come in for medical care. We’re racing to get as much training in as possible, in case there’s a resurgence. We only have a finite amount of time as trainees and we need to learn as much as we can.

What lessons have you learned from the crisis?

I’ve learned that radiology departments will have to have a backup system for staffing and designating who’s going to be in charge in the event of a crisis. We had a call schedule, but during the height of the pandemic, many residents weren’t able to come in. During that time, I remember thinking, “What if I get sick?” As chief resident, there were times when I found out an hour before someone’s shift that they were too sick to come in, and then had to scramble to find coverage. It was like suddenly working under fire. A positive change, though, has been in the scheduling of patients and procedures.

We had schedulers prior to the pandemic, but more staff have been dedicated to this purpose, with a greater emphasis on making sure patients have the appropriate labs or have stopped certain medications, and that they remain plugged into our system. This, as well as the heightened level of sanitization, has made the return to care much more streamlined and organized. There is much more attention being paid to safety, for both patients and staff.

I’ve also learned to be an effective leader. You have to lead like an economist. You have to figure out the biggest problems that affect everyone, tackle them first, and leave smaller problems for later. I also learned the importance of being a team player. Although I’m not in a leadership position now as an IR fellow at Weill Cornell Medicine, I will still be able to apply the managerial skills that I learned as chief resident to other situations.

You have to lead like an economist. You have to figure out the biggest problems that affect everyone, tackle them first, and leave smaller problems for later.

What challenges lie ahead for radiology as a result of the current health and economic crisis?

Fewer physicians seem to be retiring, and there are still hiring freezes across the country. While things are not as bad as they were this spring, the job market is still struggling. I started contacting practices last May and was fortunate to secure a job starting next summer. I keep hearing from other fellows, though, who are having to work harder for interviews.

I’m also concerned about our ability to attract new talent and trainees. A lot of medical students don’t have primary exposure to radiology, as not all schools have a rotation in it. There has also been a real paradigm shift in the way that interviews are conducted. Even now, interviews for some residency programs are virtual, and the interview process makes it difficult for applicants to make decisions.

Why do you value your ACR membership?

The ACR is the underlying force that has everyone’s back. The College delves into legislation and billing issues that affect our lives. We remain in uncertain times in radiology, especially during this pandemic, but we have the ACR to support us. To be engaged with the ACR is to be enlightened, recognizing that there are bigger issues affecting our vitality. The ACR is our safety net and works hard to ensure the continuation of our livelihoods as radiologists.