AJR Podcasts

Every radiologist can name the career decisions that worked out. Almost nobody talks about the ones that did not. Peter S. Moskowitz, MD, a pediatric radiologist turned physician career coach, speaks with hosts Surbhi Raichandani, MD, and Sherry Wang, MBBS, about burnout, sunk costs, and what comes after a wrong turn. Listen to their discussion in episode 4 of Difficult Conversations, an AJR Podcast Series.

https://www.ajronline.org/doi/10.2214/AJR.26.36011

*Key Takeaways

The Second Career: A physician's primary job is clinical excellence, but a secondary job is active career self-management, which requires finding trusted mentors and being vulnerable enough to ask for help.

The 4 D's of Transition: Recognizing the need for a career pivot may begin with identifying William Bridges' four D's of transition endings: disengagement, disidentification, disenchantment, and disorientation.

Proactive "Protirement": True retirement planning or "protirement" should begin the first day of your first paying job, involving professional financial planners and your significant other to align your long-term vision.

*Chapters

0:00 - Welcome

3:51 - Tenure Setback and Toxic Practice

5:23 - Burnout to Coaching

6:58 - Return to Academia

8:44 - Lessons From Career Transitions

12:29 - Career Resilience

14:14 - The Moment Burnout Hit

16:40 - Golden Handcuffs and Wrong Paths

19:42 - Why Burnout Happens

22:06 - Greed and Leadership Voice

26:37 - Advice for Early Attendings

31:32 - How CPPR Coaching Works

34:17 - Protirement Plan Early

39:52 - Radiologist-Centered Imaging

43:08 - Wellness Progress and What Next

49:29 - AI Efficiency Burnout Myth

55:52 - One Sentence Advice and Takeaways

59:00 - Closing

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*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

How can radiology practices evaluate AI-generated patient friendly reports in a standardized manner? Antonino Andrea Blandino, MD, discusses the article by Armstrong et al. describing a quality assessment rubric for grading such reports.

Full article: A Quality Assessment Rubric for Artificial Intelligence–Generated Patient-Friendly Radiology Reports

Imaging utilization may not be the main driver of imaging's carbon footprint. Joel Samuel, MD, discusses the article by Paul et al. on the role of grid carbon intensity in shaping variations in imaging-related greenhouse gas emissions.

Full article: Same Scan, Different Footprint: Does the Power Grid Matter More Than How Much We Image?

What do you do when images tell a different story? Bharti Khurana, MD, MBA, speaks with cohosts Lindsey Negrete, MD, and Amy Maduram, MD, about her journey from the reading room to the forefront of artificial intelligence innovation, transforming the way we identify and support survivors of intimate partner violence. Listen to their discussion in episode 4 of Extreme Radiology, an AJR Podcast Series.

https://www.ajronline.org/doi/10.2214/AJR.26.35966

*Key Takeaways

The Longitudinal Biomarker: There is no single characteristic injury that defines intimate partner violence (IPV). Instead, the true warning sign is a longitudinal pattern of trauma over time, including target injuries to the head and face, defensive injuries to the upper extremities, and neck injuries from strangulation.

Protecting the Patient Portal: Radiologists should not write "suspicious for IPV" in a formal imaging report because the partner may be monitoring the patient's electronic records. Radiologists should objectively describe the injuries in the text and directly call the referring clinician to raise abuse suspicions.

The "Pickle Jar" of Disclosure: If a case is flagged and the patient denies the abuse, the radiologist should not feel that they have failed. Reporting IPV is like opening a tight pickle jar; each safe conversation loosens the lid until the patient is finally ready and empowered to disclose their situation.

Humanizing Medicine with AI: The AIRS tool uses computational analysis to flag high probability IPV risk, which allows clinicians to better dedicate appointment times toward empathetic, trauma-informed conversations.

Bias as a Strength: Critics initially warned that radiologists could not diagnose IPV because they may not see the patient's socioeconomic background in the reading room. However, this is also a source of strength, allowing radiologists to report objective findings without certain potential implicit biases.

*Chapters

0:00 - Welcome and Content Warning

2:46 - Why Study IPV in Radiology

6:17 - Imaging Clues and Patterns

8:03 - Longitudinal Data and Integration

9:19 - Gender Differences and Misconceptions

14:33 - Reporting Safely in the EMR Era

19:00 - The Longitudinal Biomarker Eureka Moment

22:56 - AI That Prompts Human Care

25:21 - AIRS Workflow and Future Tools

30:25 - Collaboration and Leaving the Silo

34:47 - Handling Criticism and Staying Motivated

38:12 - What Trainees Should Know

41:52 - Closing Takeaways

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*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

What are drivers of stress and satisfaction in the radiology workplace? Pranjal Rai, MD, discusses this article by Ayyala et al. that explores this issue among radiologists, technologists, nurses, and other staff.

Full article: Sources of Work-Related Stress and Satisfaction in Radiology: A Survey of Faculty, Technologists, Nurses, and Other Staff

The combination of photon-counting CT and low-keV VMI has the potential to aid bladder cancer local stage Anna Lo Verde, MD, discusses the prospective study by Wang et al. exploring this combination for detecting muscle invasion.

Full article: Photon-Counting CT With Low-keV Virtual Monoenergetic Images for Detecting Muscle Invasion in Bladder Cancer: A Prospective Study

Negotiation is an important skill that physicians are rarely taught. Anees Chagpar, MD, MA, MBA, MPH, and Naman Desai, MD, speak with cohosts Winnie Hahn, MD, and Elizabeth Hecht, MD, about how preparation, practice, and a shift in mindset can help physicians negotiate with confidence and build careers that align with their values and priorities. Listen to their discussion in episode 3 of Mentorship Unfiltered, an AJR Podcast Series.

https://www.ajronline.org/doi/10.2214/AJR.26.35921

*Key Takeaways

The Collaborative Mindset: Negotiation is not a zero-sum, adversarial battle. Approaching the conversation as joint problem-solvers allows both the employer and employee to find creative ways to "grow the pie" and achieve mutual benefits.

Expanding the Target: Candidates often make the mistake of focusing exclusively on base salary. Successful negotiators research historical precedents (like AAMC data) and ask for flexible perks, such as housing stipends, free childcare, CME funding, and specific call schedules.

The Malpractice Trap: Understanding the difference between claims-based and occurrence-based malpractice insurance is critical. If a practice uses claims-based insurance, exiting the job requires tail coverage that can cost between $10,000 and $30,000; this should be negotiated upfront.

Continuous Self-Advocacy: Negotiation does not end once the initial contract is signed. Mid-career physicians should continually reassess their value and leverage employer investments.

*Chapters

0:00 - Why Negotiation Matters

4:00 - Negotiation Misconceptions

5:34 - Prepping Before First Offer

8:06 - Expand Beyond Salary

14:30 - Negotiation Phrases That Work Well?

16:16 - Avoiding Ultimatums

20:01 - Finding Market Pay Information

21:59 - Priorities and Job Stability

24:42 - W2 vs 1099

26:07 - Malpractice and Tail Coverage

28:55 - Money Priorities Checklist

31:27 - RVU Volume Reality Check

36:48 - Red Flags Researching Groups

38:25 - Switching Jobs and Credentialing

39:58 - Mid-Career Negotiation Never Ends

45:00 - Women and Negotiation Bias

52:32 - Institution Responsibilities

56:52 - Key Takeaways and Wrap Up

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*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

A strong research question can still fail if the study design cannot answer it. Michael Soulen, MD, and Shudaveep Ganguly, MD, DM, speak with host Amit Gupta, MD, about selecting meaningful outcomes, matching design to the question, avoiding pitfalls of diagnostic accuracy studies, involving statisticians early, and building multidisciplinary trials. Listen to their discussion in episode 3 of The Early Career Researcher's Playbook, an AJR Podcast Series.

*Key Takeaways

Meaningful Outcomes vs. Surrogates: Technical success and progression-free survival are only surrogate endpoints. Patients and clinicians ultimately care about overall survival and quality of life. Imaging surrogates are notoriously poor predictors of true clinical benefit.

Flaws in Diagnostic Accuracy: Relying purely on sensitivity and specificity is problematic if the study population doesn't reflect real-world conditions. Likelihood ratios may provide a realistic indication of a test's clinical impact.

Early Statistical Integration: Never treat a statistician as a data calculator at the end of a study. Engaging them during the brainstorming phase ensures feasibility and helps to properly structures your protocol and database.

*Chapters

0:00 - Welcome

2:23 - Choosing Meaningful Outcomes

9:28 - RCTs and Real World Limits

18:36 - Diagnostic Study Pitfalls

25:58 - From Accuracy to Impact

28:55 - Statistics Starts Early

37:45 - Making Collaboration Work

47:01 - Quick Fire Playbook

51:04 - Final Advice

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*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.

How can AI help predict breast cancer risk? Heta Ladumor, MD, discusses the AJR article by Xu et al. that developed a novel deep-learning tool for predicting risk from DBT examinations.

Full article: Predicting 5-Year Breast Cancer Risk From Longitudinal Digital Breast Tomosynthesis: A Single-Center Retrospective Study

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Neuroimaging utilization in the emergency department (ED) is growing. Christopher Ruggiero, MD, discusses this article by Rai et al. that explores this growth in over 3 million ED encounters nationally.

Full article: Utilization of Emergency Department (ED) Neuroimaging From 2016 to 2025: Analysis in Over 3 Million ED Encounters from the Multicenter Cosmos EHR Dataset

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