Abstract From 1990 to 2024, women neuroradiologists in North America have made tremendous progress in the areas of leadership, clinical innovation, research, education, diversity, equity and inclusion, and global outreach. This chapter begins with summaries of their key accomplishments in four broad domains, followed by short biographical sketches of numerous luminaries organized by leadership roles and areas of expertise, and ending with conclusions and future directions.

Importance Women account for only 28% of current US medical school deans. Studying the differences between women and men in their preparation to becoming deans might help to explain this discrepancy. ObjectiveTo identify differences in the leadership development experiences between women and men in their ascent to the medical school deanship. Design, Setting, and ParticipantsIn this qualitative study, volunteers from the roster of the Association of American Medical Colleges Council of Deans were solicited and interviewed from June 15 to November 9, 2023. Women deans were recruited first, then men who had been appointed to their deanships at a similar time to their women counterparts were recruited. Deans were interviewed on topics related to number of applications for deanships, prior leadership roles, leadership development, personal factors, and career trajectories. Interviews were coded, and themes were extracted through conventional content analysis. Main Outcome and MeasuresCareer and leadership development experiences were elicited using a semistructured interview guide. ResultsWe interviewed 17 women and 17 men deans, representing 25.8% (34 of 132) of the total population of US medical school deans. Most deans (23 [67.6%]) practiced a medicine-based specialty or subspecialty. No statistically significant differences were found between women and men with regard to years to attain deanship (mean [SD], 2.7 [3.4] vs 3.7 [3.7] years), years as a dean (mean [SD], 5.7 [5.2] vs 6.0 [5.0] years), highest salary during career (mean [SD], $525 769 [$199 936] vs $416 923 [$195 848]), or medical school rankings (mean [SD], 315.5 [394.5] vs 480.5 [448.9]). Their reports indicated substantive gender differences in their paths to becoming a dean. Compared with men, women deans reported having to work harder to advance, while receiving less support and opportunities for leadership positions by their own institutions. Subsequently, women sought leadership development from external programs. Women deans also experienced gender bias when working with search firms. Conclusions and RelevanceThis qualitative study of US medical school deans found that compared with men, women needed to be more proactive, had to participate in external leadership development programs, and had to confront biases during the search process. For rising women leaders, this lack of support had consequences, such as burnout and attrition, potentially affecting the makeup of future generations of medical school deans. Institutional initiatives centering on leadership development of women is needed to mitigate the gender biases and barriers faced by aspiring women leaders.

Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information. Therefore, despite great promise, diagnoses may still be incorrect, delayed, or never made. Integrative diagnostics represents a vision for the future, wherein diagnostic data, together with clinical data from the electronic health record, are aggregated and contextualized by informatics tools to direct clinical action. Integrative diagnostics has the potential to identify correct therapies more quickly, modify treatment when appropriate, and terminate treatment when not effective, ultimately decreasing morbidity, improving outcomes, and avoiding unnecessary costs. Radiology, laboratory medicine, and pathology already play major roles in medical diagnostics. Our specialties can increase the value of our examinations by taking a holistic approach to their selection, interpretation, and application to the patient's care pathway. We have the means and rationale to incorporate integrative diagnostics into our specialties and guide its implementation in clinical practice.

INTRODUCTION:Radiology has widely acknowledged the need to improve inclusion of racial, ethnic, gender, and sexual minorities, with recent discourse also underscoring the importance of disability diversity and inclusion efforts. Yet studies have shown a paucity of diversity among radiology residents, despite increasing efforts to foster diversity and inclusion. Thus, the purpose of this study is to assess radiology residency program websites' diversity statements for inclusion of race and ethnicity, gender, sexual orientation, and disability as commonly underrepresented groups. METHODS:A cross-sectional, observational study of websites of all diagnostic radiology programs in the Electronic Residency Application Service directory was conducted. Program websites that met inclusion criteria were audited for presence of a diversity statement; if the statement was specific to the residency program, radiology department, or institution; and if it was presented or linked on the program or department website. All statements were evaluated for the inclusion of four diversity categories: race or ethnicity, gender, sexual orientation, and disability. RESULTS:One hundred ninety-two radiology residencies were identified using Electronic Residency Application Service. Programs with missing or malfunctioning hyperlinks (n = 33) or required logins (n = 1) were excluded. One hundred fifty-eight websites met inclusion criteria for analysis. Two-thirds (n = 103; 65.1%) had a diversity statement within their residency, department, or institution, with only 28 (18%) having residency program-specific statements and 22 (14%) having department-specific statements. Of the websites with diversity statements, inclusion of gender diversity was most frequent (43.0%), followed by race or ethnicity (39.9%), sexual orientation (32.9%), and disability (25.3%). Race or ethnicity was most included in institution-level diversity statements. CONCLUSIONS:Less than 20% of radiology residency websites include a diversity statement, and disability is the least-included category among the diversity statements. As radiology continues to lead diversity and inclusion efforts in health care, a more comprehensive approach with equitable representation of different groups, including those with disabilities, would foster a broader sense of belonging. This comprehensive approach can help to overcome systemic barriers and bridge gaps in disability representation.

Hossein Jadvar, MD, PhD, MPH, MBA, a tenured professor in the Department of Radiology at the Keck School of Medicine of the University of Southern California (USC) in Los Angeles, talked with Carolyn C. Meltzer, MD, about her career in science and academic leadership. Dr. Meltzer became the Dean of

HomeRadiology: Artificial IntelligenceVol. 5, No. 2 PreviousNext Special CommunicationsFree AccessTruth and Transformation: RSNA's Journey Toward EquityCurtis P. Langlotz, Matthew A. Mauro, Umar Mahmood, Jeffrey S. Klein, Carolyn C. Meltzer, Sanjeev Bhalla, Richard E. Heller III, Jinel A. Scott, Adam E. Flanders, Pari V. PandharipandeCurtis P. Langlotz, Matthew A. Mauro, Umar Mahmood, Jeffrey S. Klein, Carolyn C. Meltzer, Sanjeev Bhalla, Richard E. Heller III, Jinel A. Scott, Adam E. Flanders, Pari V. PandharipandeAuthor AffiliationsFrom the RSNA Board of Directors.Curtis P. LanglotzMatthew A. MauroUmar MahmoodJeffrey S. KleinCarolyn C. MeltzerSanjeev BhallaRichard E. Heller IIIJinel A. ScottAdam E. FlandersPari V. PandharipandePublished Online:Mar 2 2023https://doi.org/10.1148/ryai.239001MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Recently, in the article “How We Got Here: The Legacy of Anti-Black Discrimination in Radiology,” published in RSNA’s journal, RadioGraphics, Goldberg et al (1) provided a clear historical look at anti-Black discrimination in the field of radiology, including within RSNA. The authors present a compelling history that connects this disturbing past both to the low representation of Black radiologists in the U.S. and to the persistent health disparities in Black communities that are evident today.In an invited commentary, RSNA board member Dr. Jinel A. Scott states: “Although acknowledging these historic events is painful and uncomfortable, to disregard them would be injurious to the specialty and directly harmful to Black physicians, radiologists, and patients.” (2)As leaders of a professional medical society that strives for inclusion, equity and diversity, we read this historical account with sadness and remorse. We applaud the authors’ important work gathering the facts and telling the unsettling story of our past. The events presented in the article likely do not represent a full accounting of RSNA’s harmful actions, but these examples are representative of actions and a time when our organization failed.Racism’s destructive impact on human welfare on all levels – psychological, physical, social, educational, and economical – is antithetical to RSNA’s mission and to our current efforts and focus. We agree with Dr. Scott that it is uncomfortable to confront the harmful actions of our past. But to deny or dismiss our historical role in anti-Black discrimination would cause further injury.We write this statement to acknowledge our historical contribution to structural racism in radiology and to apologize for RSNA’s actions that perpetuated systemic racism, both through omission and commission. We also deeply regret RSNA’s past policies and practices that have contributed to the health care disparities and inequities we see today. We recognize the profound and lasting impact these failures have had on communities of color and Black radiologists, as well as on the field of radiology. We reaffirm RSNA’s opposition to discrimination in any form and its commitment to initiatives and policies that aim to resolve these disparities and create a more equitable and inclusive society.Because an apology without action and sustained commitment has little meaning, our future actions will reflect the authenticity of this statement and our commitment to listening and learning. RSNA’s strategic plan includes the crucial goal of promoting diverse representation within the profession and ensuring diversity in RSNA leadership. But more must be done to reconcile the past and create a better future.With the help of two key RSNA groups, the Committee on Diversity, Equity and Inclusion, and the Health Equity Committee, as well as through the work of all parts of the organization, RSNA commits to the following actions:Ensure that RSNA bylaws, policies and programs are free from discriminatory practices and unconscious biases.Prioritize RSNA’s diversity, equity, and inclusion values and goals throughout the organization.Continue our assessment of gaps within RSNA leadership and volunteers, including board governance, speaking opportunities, and committee service.Identify areas of need and increase RSNA’s recognition opportunities, including awards and grant funding.Establish more equitable pathways to build diversity and address gaps within the radiology profession.Collaborate with organizations focused on improving the field of medicine for Black physicians and communities of color.Continue our commitment to reducing health care disparities and inequities within North America and throughout the world.We hope this statement, the steps we plan to take, and our commitment to create a radiology community that is inclusive, equitable and diverse, will foster healing and positive change.You can learn more about RSNA’s commitment to diversity, equity and inclusion at rsna.org/about/rsna-diversity-equity-inclusion. We invite your ideas for improving RSNA, creating a stronger radiology community and a more welcoming environment for all people. Please direct your comments, questions, ideas and suggestions to us at [email protected].REFERENCES1. Goldberg JE, Prabhu V, Smereka PN, Hindman NM. How we got here: the legacy of anti-black discrimination in radiology. RadioGraphics 2023;43(2):e220112. Link, Google Scholar2. Scott J. From unacceptable to intolerable. RadioGraphics 2023;43(2):e220190. Link, Google ScholarArticle HistoryPublished online: Mar 02 2023 FiguresReferencesRelatedDetailsRecommended Articles Truth and Transformation: RSNA's Journey Toward EquityRadiology2023Volume: 307Issue: 3Truth and Transformation: RSNA's Journey Toward EquityRadiology: Imaging Cancer2023Volume: 5Issue: 2Truth and Transformation: RSNA's Journey Toward EquityRadiology: Cardiothoracic Imaging2023Volume: 5Issue: 2Invited Commentary: From Unacceptable to IntolerableRadioGraphics2023Volume: 43Issue: 2Grassroots Approach to Forming a Diversity, Equity, and Inclusion Committee in an Academic Radiology DepartmentRadioGraphics2023Volume: 43Issue: 6See More RSNA Education Exhibits Imaging Review of the Healing Process in Sport Muscle InjuriesDigital Posters2022Overcoming Data Shift: The Challenge To Translating AI To Clinical PracticeDigital Posters2021Pocket Guide for Understand (and Successfully Apply) US and MRI Elastography TechniquesDigital Posters2019 RSNA Case Collection Femur fractureRSNA Case Collection2020Chondroblastoma of the glenoidRSNA Case Collection2021Uterine Artery PseudoaneurysmRSNA Case Collection2021 Vol. 5, No. 2 Metrics Downloaded 298 times Altmetric Score PDF download

On June 24th 2022 the US Supreme Court, in a 5-4 decision, overturned Roe v. Wade, the landmark 1973 ruling that established the constitutional right to abortion. We are radiologists and medical physicists, many of whom hold or have held leadership roles in our professional community. We are deeply concerned about this erosion of reproductive choice and bodily autonomy across the many States that will now further restrict or even ban access to abortion. Radiologists are physicians who use medical imaging - such as ultrasound, CT, and MRI - to diagnose and treat disease. We use imaging to monitor pregnancy from start to finish and have perspective on the myriad of issues that can arise, making us qualified to speak on the importance of bodily autonomy and the right to choose whether or not to proceed with a pregnancy. Diagnostic radiologists are experienced in evaluating post-surgical complications and interventional radiologists are thoroughly trained in minimally invasive techniques to stop uncontrolled bleeding and place drains to treat abscesses. "Today, approximately 21 million women around the world obtain unsafe, illegal abortions each year, and complications from these unsafe procedures account for approximately 13% of all maternal deaths, nearly 50,000 annually." 1The American College of Obstetricians and Gynecologists (ACOG). "Facts are important: abortion is healthcare." https://www.acog.org/advocacy/facts-are-important/abortion-is-healthcare#:~:text=ACOG's%20November%202017%20Statement%20of,undue%20interference%20by%20outside%20parties. Accessed May 13, 2022. These are our patients, and their morbidity and mortality is entirely preventable with access to safe and legal abortion. We support our patients, of all genders, in making their own informed decisions about their healthcare and management. We urge lawmakers and policy makers to ensure access to reproductive health including safe, legal abortion to all who need these essential healthcare services. Signed Aditya Karandikar, MD A.J. Mariano, MD Adam A. Dmytriw, MD, MPH, MSc Agnieszka Solberg, MD Alan H. Matsumoto, MD Alda L. Tam, MD Alexandra H. Fairchild, MD Alexia Tatem, MD, MPH Alexie Riofrio, MD Alice Fung, MD Alice Zhou, MD Alison Roth, PhD Allison Gittens, MD Ami A. Shah, MD Amie Y. Lee, MD, FSBI Amina Farooq, MD Amit Chakraborty, MD Amy C. Taylor, MD Amy Killeen, MD Amy L. Kotsenas, MD, FACR Amy Lynn Conners, MD Amy Oliveira, MD Anand Narayan, MD, PhD Andi Senter, MD Andrea A. Birch, MD, FACR Andrew Bruner, MD Aneesa Majid, MD, MBA, FSIR Angela Tong, MD Anika L. McGrath, MD Anjali Malik, MD Ann Leylek Brown, MD Anna Nidecker, MD Anne C. Hoyt, MD Anne Roberts, MD Arjun Patel, MD Arthur Fleischer, MD, FACR, FAIUM, FSRU Asha Sarma, MD Ashley Hastings-Robinson, MD Babak Rejaie, MD Bahar Mansoori, MD Bamidele F. Kammen, MD Benjamin Meyer, MD Beth Vettiyil, MD Beth Zigmund, MD Bindu Avutu, MD, MPH Brian Latimer, MD, PhD Brian Park, MD Brooke Morrell, MD Bruce Curran, MS, ME Cameron Henry, MD Camilo Jaimes, MD Cara Connolly, MD Caroline Robson, MBChB Carolyn C. Meltzer, MD, FACR Carolynn DeBenedectis, MD Cassy L. Cook, MD Catherine Everett, MD, MBA, FACR Catherine H. Phillips, MD Chelsea Dunning, PhD Chelsea Neesham, MD Cheri L. Canon, MD, FACR, FSAR Christian Fauria-Robinson, MD Christie M. Lincoln, MD Christine Dove, MD Christine Glastonbury, MBBS Christine Rehwald, MD Christopher Hess, MD, PhD Christopher Murphy, MD Christy Pomeranz, MD Claudia F.E. Kirsch, MD, PhD Cody Quirk, MD Constantine M. Burgan, MD Courtney Scher, DO Courtney Tomblinson, MD Cristina Fuss, MD Cynthia Santillan, MD Dania Daye, MD, PhD Daniel B. Brown, MD, FSIR Daniel J. Young, MD Daniel Kopans MD Daniel Vargas, MD Dann Martin, MD, MS Darren L. Transue, MD David Thompson, MD David W. Jordan, PhD, FACR, FAAPM Deborah Shatzkes, MD Derek Sun, MD Desiree M. Clement, MD Domenico Mastrodicasa, MD Doris Lin, MD, PhD Edward Lo, MD Elainea Smith, MD Elena Korngold, MD Eleza Golden, MD Elianna L. Goldstein, MD, MS Elizabeth A. Russ, MD Elizabeth England, MD Elizabeth H. Dibble, MD Elizabeth K. Arleo, MD, FACR, FSBI Elizabeth M. Hecht, MD, FSAR Elizabeth Morris, MD Elizabeth P. Maltin, MD, FACR Elizabeth Snyder, MD Emmanuel Carrodeguas, MD Erin A. Cooke, MD Erin Shropshire, MD Erin Simon Schwartz, MD, FACR Etta Pisano, MD Evan Lehrman, MD Faezeh Sodagari, MD Faisal Shah, MD, MBA Florence X. Doo, MD Francesca Rigiroli, MD George K. Vilanilam, MD Geraldine McGinty, MD Gina Landinez, MD Girish Bathla, MD Grace G. Zhu, MD Grace Gwe-Ya Kim, PhD Graham Keir, MD Habib Rahbar, MD Hailey Choi, MD Harmanpreet Bandesha, DO Harrison Lee, MD, MBA Haydee Ojeda-Fournier, MD, FSBI Heather Early, MD Heather Greenwood, MD Ichiro Ikuta, MD, MMSc Irena Dragojevic, PhD J. Hugo Decker MD, PhD James Matthew Kerchberger, MD, MPH Jamie Holtz, MD Jamie Hui, MD Jamie Lee Twist Schroeder, MD, DPhil Jana Ivanidze, MD, PhD Janine T. Katzen, MD Jason Chiang, MD, PhD Jeffers Nguyen, MD Jeffrey D Robinson, MD, MBA, FACR Jeffrey Shyu, MD, MPH, MA Jennifer C. Broder, MD Jennifer Chen, MD Jennifer J. Wan, MD Jennifer Kemp, MD, FACR Jennifer R. Buckley, MD, MBA Jennifer S. Weaver, MD Jesse M. Conyers, MD Jessica B. Robbins, MD Jessica Hayward, MD Jessica R. Leschied, MD Jessica Wen, MD, PhD Jiyon Lee, MD Jocelyn Park, MD Joelle Wazen, MD John Mongan, MD, PhD Jonathan Breslau, MD Jordan Cuskaden, MD Jordan Perchik, MD José Pablo Martínez Barbero, MD, PhD, EDiNR Jubin Jacob, MD Julia Schoen, MD, MS Justin Banaga, MD Kalpana Kanal, PhD, FACR Karla A. Sepulveda, MD Karyn Ledbetter, MD Katarzyna J. Macura, MD, PhD Katherine E. Maturen, MD MS Katherine Frederick-Dyer, MD Kathleen A. Ward, MD, FACR, FAAWR Kathryn McGillen, MD Katia Dodelzon, MD, FSBI Katie M. Davis, DO Kayla Cort, DO Kelly Kisling, PhD Kemi Babagbemi, MD, FACR Kevin C. McGill, MD, MPH Kevin J. Chang, MD, FACR, FSAR Kevin Terashima, MD Khashayar Farsad, MD, PhD Kimberly Feigin, MD Kimberly Kallianos MD Kimberly McFarland, MD Kimberly S. Winsor, MD Kimberly Seifert, MD, MS Kirang Patel, MD Kristin K. Porter, MD, PhD, FSAR Kristin M. Foley, MD Krupa Patel-Lippmann, MD Lacey J. McIntosh, DO Laura Barkley, MD Laura E. Heyneman, MD Laura Padilla, PhD Lauren Groner, DO Lauren M. Harry, MD, MS Lauren M. Ladd, MD Laurie Abrams, MD Leah H. Portnow, MD Leah Schafer, MD Leah Sieck, MD Leonard Morneau, MD Leslie Allen, MD Lindsay Busby, MD, MPH Lisa Kang, MD Lisa Walker, MD Lisa Wang, MD, MBA, MPH Lori Strachowski, MD, FSRU, FAOCR Lucy B. Spalluto, MD, MPH Luyao Shen, MD M Mahesh, MS, PhD, FAAPM, FACR, FACMP, FSCCT, FIOMP M. Victoria Marx, MD Majid Chalian, MD Margaret Fleming, MD, MSc Mariam Moshiri, MD Marianne R. Petruccelli, MD Mark D. Sugi, MD Mark P. Supanich, PhD Marla B.K. Sammer, MD, MHA Mary Tenenbaum, MD Maryellen Sun, MD, FACR, FSAR Masis Isikbay, MD Matthew J. Barkovich, MD Matthew J. Miller, MD Matthew S. Johnson, MD Maya Vella, MD Melika Rezaee, MD Melissa A. Davis, MD, MBA Melissa M. Chen, MD Meredith S. Byers, MD Meridith J. Englander, MD, FSIR, FACR Michael Durst, MD Michael Oumano, PhD Michael S. McCollum, DO Michelle Ouyang, MD Mignonne B. Morrell, MD Mitva Patel, MD Monica J. Wood, MD Morgan P. McBee, MD Nancy J. Fischbein, MD Narasim S. Murthy, MD Nataliya Kovalchuk, PhD Neil Lall, MD Neville Eclov, PhD Nicole Kurzbard Roach, MD Nikhil Madhuripan, MD Nikki S. Ariaratnam, MD Nina S. Vincoff, MD Nishanth Khanna, MD Nishita Kothary, MD, FSIR Noushin Yahyavi-Firouz-Abadi, MD Olga R. Brook, MD Orit A. Glenn, MD Pamela K. Woodard, MD Parag J. Patel, MD, MS Parisa Mazaheri, MD Patricia Rhyner MD, FACR Peter R. Eby, MD, FACR Pradnya Mhatre, MD Preethi Raghu, MD Priyanka Jha, MBBS Rachel F. Gerson, MD Rebecca Milman, PhD Rina Patel, MD Robert L. Gutierrez, MD Robert Marks, MD Robyn Gebhard, MD Rochelle F. Andreotti, MD, FACR, FAIUM, FSRU Rohini Nadgir, MD Rukya Masum, MD Ruth B. Goldstein, MD Ryan Manger, PhD Ryan Woods, MD, MPH Sabala Mandava, MD Samantha G. Harrington, MD, MSc Samir Parikh, MD, FACR Sammy Chu, MD, FRCPC Sandeep S. Arora, MBBS Sandra M. Meyers, PhD Sanjay Prabhu, MBBS Sara Shams, MD, PhD Sarah Nobles, MD Sarah Pittman, MD, FRCPC Sarah Rothan, MD Sejal N. Patel, MD Shabnam Mortazavi, MD, MPH Shalini V. Mukhi, MD Sheila Enamandram, MD, MBA Shelby Payne, MD Shravan Sridhar MD, MS Stephen Stein, MD, FACR Steven P. Poplack, MD Steven W. Hetts, MD, FACR Susan Richardson, PhD Suzanne Shepherd, MD Tarek A. Hijaz, MD Teresa Chapman, MD Theresa Caridi, MD, FSIR Thomas W. Loehfelm, MD, PhD Tiffany L. Chan, MD Tim Jenkins, MD Tina Shiang, MD Titania Juang, PhD Toshimasa J. Clark, MD Uzma Waheed, MD Valeria Potigailo, MD Vasantha Aaron, MD Vinil Shah, MD Virginia Planz, MD Vivek Kalia, MD, MPH Walid Ashmeik, MD Wendy DeMartini, MD William D. Donovan, MD, MPH, FACR William P. Dillon, MD Yasha Gupta, MD Yi Li, MD Yilun Koethe, MD Zachary Hartley-Blossom, MD, MBA Zhen Jane Wang, MD These views reflect the opinions of the authors only and do not equal endorsement from their associated affiliations.

The year 2020 was an awakening into the racial disparities that exist across the United States and within health care. Global protests after the murder of George Floyd were a poignant recognition of the disproportionate—and often deadly—burden for those who identify as Black, Indigenous, and People of Color (BIPOC). Systemic inequalities within our health system are well documented. From birth to death, BIPOC Americans experience poorer health outcomes than White Americans. For example, Black women have lower screening mammography rates than White women [1], which contributes to higher mortality rates due to higher-grade malignancies and later-stage diagnoses.

RATIONALE AND OBJECTIVES:Limited exposure to radiology by medical students can perpetuate negative stereotypes and hamper recruitment efforts. The purpose of this study is to understand medical students' perceptions of radiology and how they change based on medical education and exposure.MATERIALS AND METHODS:A single-institution mixed-methods study included four groups of medical students with different levels of radiology exposure. All participants completed a 16-item survey regarding demographics, opinions of radiology, and perception of radiology stereotypes. Ten focus groups were administered to probe perceptions of radiology. Focus groups were coded to identify specific themes in conjunction with the survey results.RESULTS:Forty-nine participants were included. Forty-two percent of participants had positive opinions of radiology. Multiple radiology stereotypes were identified, and false stereotypes were diminished with increased radiology exposure. Opinions of the impact of artificial intelligence on radiology closely aligned with positive or negative views of the field overall. Multiple barriers to applying for a radiology residency position were identified including board scores and lack of mentorship. COVID-19 did not affect perceptions of radiology. There was broad agreement that students do not enter medical school with many preconceived notions of radiology, but that subsequent exposure was generally positive. Exposure both solidified and eliminated various stereotypes. Finally, there was general agreement that radiology is integral to the health system with broad exposure on all services.CONCLUSION:Medical student perceptions of radiology are notably influenced by exposure and radiology programs should take active steps to engage in medical student education.

Rationale and Objectives: Female physicians in academic medicine have faced barriers that potentially affect representation in different fields and delay promotion. Little is known about gender representation differences in United States academic radiology departments, particularly within the most pursued subspecialties. Purpose: To determine whether gender differences exist in United States academic radiology departments across seven subspecialties with respect to academic ranks, departmental leadership positions, experience, and scholarly metrics. Materials and Methods: In this cross-sectional study from November 2018 to June 2020, a database of United States academic radiologists at 129 academic departments in seven subspecialties was created. Each radiologist's academic rank, departmental leadership position (executive-level - Chair, Director, Chief, and Department or Division Head vs vice-level - vice, assistant, or associate positions of executive level), self-identified gender, years in practice, and measures of scholarly productivity (number of publications, citations, and h-index) were compiled from institutional websites, Doximity, LinkedIn, Scopus, and official NPI profiles. The primary outcome, gender composition differences in these cohorts, was analyzed using Chi(2) while continuous data were analyzed using Kruskal-Wallis rank sum test. The adjusted gender difference for all factors was determined using a multivariate logistic regression model. Results: Overall, 5086 academic radiologists (34.7% women) with a median 14 years of practice (YOP) were identified and indexed. There were 919 full professors (26.1% women, p < 0.01) and 1055 executive-level leadership faculty (30.6% women, p < 0.01). Within all subspecialties except breast imaging, women were in the minority (35.4% abdominal, 79.1% breast, 12.1% interventional, 27.5% musculoskeletal, 22.8% neuroradiology, 45.1% pediatric, and 19.5% nuclear; p < 0.01). Relative to subspecialty gender composition, women full professors were underrepresented in abdominal, pediatric, and nuclear radiology (p < 0.05) and women in any executive-level leadership were underrepresented in abdominal and nuclear radiology (p < 0.05). However, after adjusting for h-index and YOP, gender did not influence rates of professorship or executive leadership. The strongest single predictors for professorship or executive leadership were h-index and YOP. Conclusion: Women academic radiologists in the United States are underrepresented among senior faculty members despite having similar levels of experience as men. Gender disparities regarding the expected number of women senior faculty members relative to individual subspecialty gender composition were more pronounced in abdominal and nuclear radiology, and less pronounced in breast and neuroradiology. Overall, h-index and YOP were the strongest predictors for full-professorship and executive leadership among faculty.

In 2012, the United States Supreme Court struck down existing legislative statutes mandating life without parole sentencing of convicted homicide offenders under age 18. The Court's core rationale credited research on brain development that concludes that juveniles are biologically less capable of complex decision-making and impulse control, driven by external influences, and more likely to change. Closer scrutiny of the research cited in the defendants' amicus brief; however, reveals it to be inherently flawed because it did not include relevant populations, such as violent offenders; utilized hypothetical scenarios or games to approximate decision-making; ignored research on recidivism risk; made untenable leaps in their interpretation of relevance to the study of homicide, and failed to include contradictory evidence, even from the brief's authors. In forensic assessment, a blanket assumption of immaturity based on a homicide offender's age is not appropriate, as research has demonstrated that in relevant respects, older adolescents can be just as mature as adults. An individualized and thorough assessment of each juvenile offender, including an analysis of personal history, behavioral evidence such as pre, during, and post crime behavior, and testing data more accurately inform questions of immaturity and prognosis in juvenile violent offenders.

Objective: To understand how women and historically underrepresented minority medical students perceive radiology as a potential career choice.Methods: Medical students representing a broad spectrum of radiology exposure from a single institution were invited to participate in a mixed-methods study. Participants completed a 16-item survey about demographics and perceptions of radiology. Ten focus groups were administered to probe decision making regarding career selection. The themes influencing women and historically underrepre-sented minority students are presented.Results: Forty-nine medical students, including 29 (59%) women and 17 (35%) underrepresented minorities, participated. Most participants (28 of 48, 58%) reported men outnumbered women in radiology. Female participants reported a lack of mentorship and role models as major concerns. Outreach efforts focused on the family-friendly nature of radiology were viewed as patronizing. De-mographic improvements in the field were viewed as very slow. Forty-six percent (22 of 48) of participants indicated that radiology had a less underrepresented racial or ethnic workforce than other medical specialties. Minority participants especially noted a lack of radiology presence in mainstream media, so students have few preconceived biases. A failure to organically connect with the mostly White male radiologists because of a lack of shared background was a major barrier. Finally, participants described a hidden curriculum that pushes minority medical students away from specialty fields like radiology and toward primary care fields to address underserved communities and health care disparities.Discussion: Women and historically underrepresented minority medical students perceive major barriers to choosing a career in radiology. Radiology departments must develop sophisticated multilevel approaches to improve diversity.

The recent advances in artificial intelligence (AI) and its expanding adoption in medicine demand new approaches to ethical consideration. This is because the intersection between AI and medicine is increasingly occurring outside academic hospitals that serve as the scope for most IRBs. The COVID-19 pandemic highlighted the effects of systemic racism on health, as manifested by the disproportionate burden of COVID-19 disease among traditionally marginalized populations, namely, Black and Hispanic groups [Wiley, et al. J Racial Ethn Health Disparities, 2021]. This and other disparities should serve as catalysts to rethink how we build AI systems. Expanding on the ethics statement from several radiology societies in North America and Europe, we describe examples of ethical challenges on data, algorithm, and practical deployment of artificial intelligence. Thereafter we discuss strategies to mitigate this bias and provide a roadmap for future directions for the evolving ethical landscape.

Severe acute respiratory syndrome coronavirus 2 has spread across the world since December 2019, infecting 100 million and killing millions. The impact on health care institutions during the coronavirus disease 2019 pandemic has been considerable, with exhaustion of institutional and personal protective equipment resources during local outbreaks and crushing financial consequences for many institutions. Establishing adaptive principles of leadership is necessary during crises, fostering quick decision-making and workflow modifications, while a rapid review of data must determine necessary course corrections. This report describes concepts of crisis leadership teams that can help maximize their effectiveness during the current and future pandemics. (C) RSNA, 2021

In this issue of Academic Radiology, Pitot et al. ( 1 Pitot, MA, White, MA, Edney. E, et al. The Current State of Gender Discrimination and Sexual Harassment in the Radiology Workplace: A Survey Academic Radiology In Press Corrected Proof Published online: January 22, 2021 Google Scholar ) present a survey study aimed at shedding light on the extent of gender discrimination and sexual harassment in radiology and examining potential mediating institutional factors. The profession of radiology remains stubbornly male-dominated, with only minor gains in female representation over the past several decades ( 2 Hunter SA Bhatt K. Women in radiology: lessons learned in imaging and beyond. JACR. 2019; 16: 1499-1503https://doi.org/10.1016/j.jacr.2019.03.005 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar ). Given the track record of longstanding underrepresentation of women radiologists – globally and especially in the United States – there is also an outsized influence of men among the ranks of leadership such as department chairs and in powerful roles such as editorial boards ( 3 Quak E Girault G Thenint MA et al. Author gender inequality in medical imaging journals and the COVID-19 pandemic. Radiology. 2021; 300: E301-E307 Crossref PubMed Scopus (15) Google Scholar , 4 Cater SW Lowell DA Campbell JC et al. Bridging the gap: identifying global trends in gender disparity among the radiology physician workforce. Acad Radiol. 2018; 25: 1052-1061 Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar ). It is factors such as these – a male-dominated field rife with hierarchical and dependent relationships – that come to together to foster a culture conducive to both a high prevalence and the normalization of sexual and gender harassment of women ( 5 National Academies of Science, Engineering, and MedicineJohnson PA Widnall SE Benya FF Sexual harassment of women, climate, culture, and consequences in academic sciences, engineering, and medicine. The National Academies Press, Washington, DC2018https://www.nationalacademies.org/our-work/sexual-harassment-in-academia Google Scholar ). Pitot et al. ( 1 Pitot, MA, White, MA, Edney. E, et al. The Current State of Gender Discrimination and Sexual Harassment in the Radiology Workplace: A Survey Academic Radiology In Press Corrected Proof Published online: January 22, 2021 Google Scholar ) sought both to measure the prevalence in radiology and to assess whether another important variable, that of organizational tolerance, had an impact on this measure.

Since the first case of coronavirus disease 2019 (COVID-19) in the United States, it has created worldwide upheaval in health and the delivery of health care to its victims [1,2].As of this writing, this novel virus has killed almost 220,000 Americans.As leaders in the field of neuroradiology, we are writing to express our concerns about the public statements of one of our neuroradiology colleagues, Dr Scott Atlas, MD.We do not take this action lightly.These statements have included misrepresentations of the available scientific evidence about "herd immunity" as a public health strategy for COVID-19 [3].Further unsubstantiated statements, devoid of scientific evidence or scholarship, misrepresent the safety of children returning to school and cast doubt on the advice of leading epidemiologists and other public health scientists and experts on this and related activities [4].In the interest of public health, we urge citizens and institutions to look to our infectious disease and epidemiology colleagues to lead during this or any other global pandemic.We call on our radiology colleagues and other specialties to join us in the active representation of medical ethical principles to minimize harm and to rely on sound science by speaking to the evidence and partnering with those who are trained and knowledgeable to guide the public during this challenging time.

Our health care institution and our radiology department are in the midst of a Lean transformation journey [ 1 van Rossum L. Aij K.H. Simons F.E. et al. Lean healthcare from a change management perspective. J Health Organ Manag. 2016; 30: 475-493 Crossref PubMed Scopus (37) Google Scholar , 2 Kaplan G.S. Patterson S.H. Ching J.M. Blackmore C.C. Why Lean doesn't work for everyone. BMJ Qual Saf. 2014; 23: 970-973 Crossref PubMed Scopus (61) Google Scholar ]. To establish the standard work and the structure that will enable frontline problem identification, solution implementation, and hierarchical support, we have been transforming our operations and communication strategies. A tool in this process is a daily management system (DMS) using a structured and tiered huddle system [ 3 Donnelly L.F. Daily readiness huddles in radiology-improving communication, coordination, and problem-solving reliability. Curr Probl Diagn Radiol. 2017; 46: 86-90 Crossref PubMed Scopus (6) Google Scholar , 4 Donnelly L.F. Basta K.C. Dykes A.M. et al. The daily operational brief: fostering daily readiness, care coordination, and problem-solving accountability in a large pediatric health care system. Jt Comm J Qual Patient Saf. 2018; 44: 43-51 PubMed Google Scholar , 5 Donnelly L.F. Cherian S.S. Chua K.B. et al. The daily readiness huddle: a process to rapidly identify issues and foster improvement through problem-solving accountability. Pediatr Radiol. 2017; 47: 22-30 Crossref PubMed Scopus (13) Google Scholar , 6 Joshi H. Heilbrun M.E. Saindane A. et al. Radiology reading room huddles: our initial experience. AJR Am J Roentgenol. 2019 Feb 19; (Epub ahead of print.): 1-7https://doi.org/10.2214/AJR.18.20423 Crossref PubMed Scopus (2) Google Scholar ].

The editorial independence of biomedical journals allows flexibility to meet a wide range of research interests. However, it also is a barrier for coordination between journals to solve challenging issues such as racial bias in the scientific literature. A standardized tool to screen for racial bias could prevent the publication of racially biased papers. Biomedical journals would maintain editorial autonomy while still allowing comparable data to be collected and analyzed across journals. A racially diverse research team carried out a three-phase study to generate and test a racial bias assessment tool for biomedical research. Phase 1, an in-depth, structured literature search to identify recommendations, found near complete agreement in the literature on addressing race in biomedical research. Phase 2, construction of a framework from those recommendations, provides the major innovation of this paper. The framework includes three dimensions of race: 1) context, 2) tone and terminology, and 3) analysis, which are the basis for the Race Equity Vetting Instrument for Editorial Workflow (REVIEW) tool. Phase 3, pilot testing the assessment tool, showed that the REVIEW tool was effective at flagging multiple concerns in widely criticized articles. This study demonstrates the feasibility of the proposed REVIEW tool to reduce racial bias in research. Next steps include testing this tool on a broader sample of biomedical research to determine how the tool performs on more subtle examples of racial bias.