Resolutions may be cliché, but goal setting is not. People who take the time to consider their goals and create a written plan by which to achieve them tend to be more successful. Of course, simply writing things down doesn't make it so. Any achiever must do the tasks necessary to move the plan along. Medical Imaging spoke to some very busy and successful professionals to develop 10 resolutions that can help enhance your career when put into action.

1) Know thyself.

First and foremost, professionals should know their strengths and weaknesses, their likes and dislikes, their behavioral patterns, and their dreams. Many people don't take the time needed for self-reflection.

Charles Stuart Platkin is the author of Breaking the Pattern, which provides insight into eliminating negative behavior patterns and establishing positive ones.

"The working adult world is not set up to accommodate a lot of inner and silent reflection," says author and behavioral change expert Charles Stuart Platkin in his book Breaking the Pattern. He points out that great achievers throughout history, such as Sigmund Freud, Virginia Woolf, and Mahatma Gandhi, engaged in regular introspection.

Knowledge about oneself can help determine future aspirations, work and learning styles, and relationship patterns as well as guide current decision-making. "When someone is trying to improve his career or behavior, it helps to understand why he is doing what he is doing," Platkin notes. "When faced with a choice, say between doing something fun and working, knowing that a specific goal exists and why can help someone make the right decision."

2) Set goals.

Having aspirations will help to set goals, but it also helps to keep those aims reasonable. "I'm 42 years old and have no engineering background. If I were to decide I wanted to be an astronaut, I'm setting myself up for failure," Platkin says.

In his book, Platkin outlines a goal-setting process called SMART for specific, motivating, achievable, rewarding, and tactical aims. SMARTER goals call for evaluation and revision. Platkin provides more details:

• Specific: A clearly defined goal will provide a target and means of measurement. Avoid the general, "I want to be better at my job." Instead, say, "I want to make this much money or achieve this title."
• Motivating: "You should tailor your goals so that they are exciting," Platkin advises. "Don't start with a goal of being published if you hate writing. Begin with something in your realm of enjoyment."
• Achievable: "Set goals that you know in your heart you can and truly want to achieve," Platkin writes. "You have to know and be honest about your own capabilities, understand the nuts and bolts of the goals you set, and fit all the details into a time frame that's manageable."
• Rewarding: Achievable goals, however, shouldn't necessarily translate to goals that are easy. Platkin warns that if a goal is not demanding, one ends up losing interest in pursuing it. "High and daring goals tend to expand your sense of what is possible," he notes.
• Tactical: Write down the goal, complete with its components and details. Platkin suggests that this process not be rushed. "People spend months planning a wedding or a vacation. This same amount of care should be applied to one's career," he says.
• Evaluate: Both long- and short-term goals should be periodically evaluated. Charts, journals, and schedules can help mark your progress.
• Revision: Once evaluated, revision could be in order. "The plan might change as you go along. You might realize something is unrealistic or unenjoyable," he says. Reality and new information will force adaptation.

3) Do your job well.

Knowing yourself and your goals can help focus your career efforts, but whatever your aspirations, you will want to do your job well. Being late, treating patients poorly, and making mistakes will be noticed and could harm your reputation as well as chances for advancement. Excelling in one's position, with disciplined work habits and a positive attitude, will open opportunities, both within the institution and the industry at large.

The first step in the process is to know the job and know it well. "Nothing should take a physician away from gathering the breadth and depth of knowledge needed to perform a job well," says Martin P. Sandler, MD, professor and chairman of radiology and radiological sciences at Vanderbilt University (Nashville, Tenn) and VP-elect of the Society of Nuclear Medicine (Reston, Va). "New physicians should first consolidate and then broaden their medical knowledge before taking on too many outside tasks."

4) Specialize.

One way to help improve job performance is to specialize. The Renaissance man will not succeed in the medical field, where knowing a little about a lot doesn't help practitioners. Rather, it helps to know a lot about one small specialty.

"Residents must know everything to some extent to pass their boards, but it's impossible to stay up to date and know everything about all of radiology throughout one's career. Specializing makes it easier to stay abreast of advances and become an expert," says Judith Amorosa, MD, clinical professor of radiology at the University of Medicine and Dentistry New Jersey Robert Wood Johnson Medical School (Piscataway, NJ). Amorosa is the school's program director of the radiology residency and clerkship director in the radiology department and is also immediate past president of the Alliance for Medical Student Educators in Radiology, a section of the Association of University of Radiologists (Oak Brook, Ill).

Sue C. Kaste, DO, of St Jude Children's Research Hospital says that the more members invest in an association, the more they will gain.

Keeping up with the latest research becomes easier when one can focus on a smaller area of interest, targeting which journals to read, which societies to join, and which conferences to attend. Individuals can rely on one method more than another, depending on their likes. "Someone might prefer curling up with a journal to sitting in class, and there are opportunities for all," says Sue C. Kaste, DO, of the Department of Radiological Sciences at St Jude Children's Research Hospital (Memphis, Tenn) and the Radiological Sciences Department at the University of Tennessee (Memphis).

Amorosa advises taking advantage of one of the many fellowships available today that make it possible to achieve this goal of specializing early in one's career. Areas for subspecialty include pediatrics, women's healthcare, thoracic radiology, MRI, body imaging, interventional radiology, and ultrasound.

Some physicians can even become board certified in their subspecialty. "The challenge is developing the right tests so that some general knowledge is required, but the focus is on the specialty," Amorosa says. "Currently, new physicians must be recertified every 10 years.

5) Participate in lifelong learning.

Recertification and required continuing medical education (CME) already demand that physicians stay abreast of the latest advances in their field, but the concept of lifelong learning is now exerting a greater influence on curricula. The American Board of Radiology (ABR of Tuscon, Ariz) issues primary certificates in diagnostic radiology and oncology and radiologic physics as well as subspecialty certificates in neuroradiology, nuclear radiology, pediatric radiology, and vascular and interventional radiology.

With the establishment of these time-limited certificates, the organization has moved from recertification programs to a maintenance of certification (MOC) process.

The ABR-MOC has four components (professional standing, lifelong learning and self-assessment, cognitive expertise, and assessment of performance in practice) that focus on six competencies (medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice). Physicians need to show evidence of professional standing, such as an unrestricted license to practice medicine; participation in lifelong learning, with CME activities and a self-assessment process; cognitive expertise evaluated with a proctored, computer-based examination; and an assessment of his or her performance in practice, which looks at such aspects of a physician's practice as professionalism and communication skills.

Ellen B. Lipman, RT(R)(MR), of the ASRT says folks should question how something can be done better.

Technologists also are required to continue the learning process beyond their initial degree. Since 1995, continuing education (CE) has been mandatory for radiologic technologists (RTs) certified by the American Registry of Radiologic Technologists (ARRT of St Paul, Minn). Each RT must earn 24 CE credits every 2 years. "Learning doesn't end with graduation," says Ellen B. Lipman, RT(R)(MR), director of professional development for the American Society of Radiologic Technologists (ASRT of Albuquerque, NM). She predicts that curricula will change within the next 5 years to incorporate lifelong learning.

Whatever the specialty, education can take place in whatever environment best suits one's learning abilities. Practitioners can attend formal classes, participate in seminars at conferences, or take classes online. Internet options are one of the fastest growing segments of CE. In September, the ASRT Online Learning Center went live following a license agreement with Royal Philips Electronics (New York). The program offers more than 100 CE products that are available 24/7.

The online center cites a recent ASRT study, which found that its members would seek educational opportunities even if they were not required. Technology is changing rapidly. Professionals need to be aware of how it works and what its capabilities are to maximize its potential. "There is always the question of how things can be done better," Lipman says.

Some medical imaging professionals also might need to ask how to run a center better. "Many physicians need a deeper understanding of business to run their facilities successfully," says Sandler, who also believes information delivery will be reengineered to accommodate lifelong learning. "Those in leadership roles are constantly modifying their business models to generate margins that support the institution." Lifelong learning in this area is valuable as well.

6) Join the right societies.

Information also can be gathered outside the classroom from professional associations, whether delivered through publications, events, or networking. Time can be a limiting factor, so professionals should join only those societies from which they can benefit or which serve their areas of interest.

"Joining a society gives one a voice," Kaste says. "Associations influence industry and gather data. This information can push vendors to produce products to fill a specific need or can help guide the future research of members."

For a complete list of professional organizations serving the medical imaging industry, their mission statement, and current contact information, visit our resources page.

7) Attend society meetings.

Professionals can gain more from their society by attending its meetings. Association events are filled with opportunities for learning, not only from any associated seminars or conferences but also from networking. According to Sandler, meeting colleagues in similar positions allows physicians, technologists, and administrators to hear solutions from around the country.

"Meetings are a great opportunity to network, gather ideas, and compare problems and solutions," Lipman says. "Larger shows, such as RSNA, also allow attendees to see the latest and greatest in products and services."

Of course, at a show as large as the RSNA's, which drew about 60,000 attendees to the 2004 event, it's important to plan one's visit. "You must be organized to see everything you want to see," says Amorosa, who uses an event's Web site to select her classes and determine which exhibitors she must see and which events she wants to attend before leaving her office.

8) Volunteer with societies.

A plethora of networking opportunities is available at events, but professionals can develop a greater camaraderie with colleagues by volunteering for committees and study groups within their society. "Working with colleagues from around the country allows you to really develop a network that you can turn to when faced with a question or problem you cannot solve," Lipman says.

Kaste concurs, adding, "The more you invest, the more you gain. You can benefit simply by attending a meeting and absorbing information like a sponge, but you can gain more from direct interaction with the fellows of the society [to] further influence the forward motion of a group."

Lipman notes that helping an organization with its tasks improves the situation for everyone in the industry. Associations introduce programs, such as certifications, guidelines, and learning programs, that affect everyone.

9) Share your knowledge by speaking or teaching.

Professionals also can influence the future of their industry by taking advantage of speaking and teaching opportunities. Many presenters also report a sense of gratification as reward. "There is satisfaction in sharing knowledge, and teaching becomes part of the lifelong learning experience," Lipman says.

But other benefits emanate as well. "Those who are extremely well versed could find that they make a significant amount of money, too," Amorosa adds. And Kaste notes that participating in teaching opportunities causes one to look at his or her clinical work differently. "Medical imagers who also teach will ask themselves if this is a good case to present," she says.

Teachers and mentors can influence an undergraduate to enter a field simply with their enthusiasm. "Today's knowledge is the basis for the next generation of physicians, scientists, and researchers," Kaste says. "It's part of our obligation to prime this group for their work."

10) Manage your time wisely.

Of course, handing down knowledge is not the only obligation professionals in the medical imaging field must meet, and it can be easy to become overwhelmed with duties. Amorosa reports working after hours to meet her obligations, frequently an extra 2–3 hours a night.

Time-management techniques can help with prioritizing and scheduling. "It's important to pick and choose activities," Kaste says. Prioritizing becomes easier when the planner keeps set goals in mind. Knowing what you need to achieve helps determine which tasks must be accomplished, which should be accomplished, and which could be accomplished. Time-management experts advise starting with those tasks on the must-do list and then moving to the shoulds and coulds. Delegation of some tasks also can help in accomplishing everything.

"Busy professionals still have to fit in life, including jury duty, vacations, and family time," says Kaste, who relies on multitasking to get her through her days. Time should be scheduled for exercise, stress management, and just plain fun. "Burnout is a risk," says Amorosa, who cites her enthusiasm as one of the reasons she stays motivated.

Support systems, including colleagues, the department, the institution, and one's family, also can help. Sandler believes that organizations should recognize which persons have a talent for certain tasks and provide them some opportunity during work hours to achieve them. "Some people will naturally have a flair for activities outside their job specifications," Sandler says. "They should be encouraged in their efforts. Their representation of their organization or their leadership will benefit the entire practice."

These benefits will positively affect the patients and healthcare as a whole. Those who can influence this sphere will reap rewards, both tangible and intangible. Only you will know which one motivates you, and if not, see resolution number one.

Renee DiIulio is a contributing writer for Medical Imaging.

Guidelines Improve Care Life is full of decisions. They can be as broad as deciding on a career or as specific as determining which modality to use in making a diagnosis. Fortunately, medical imaging professionals need not make all their decisions on their own. Associations frequently develop clinical guidelines to help practitioners in their diagnosis and treatment process. The American College of Radiology (ACR of Reston, Va) has been developing such guidelines since 1993, when the organization determined, based on demand, that "there was an immediate need for nationally accepted, scientifically based appropriateness criteria to assist radiologists and referring physicians in making appropriate imaging decisions for given patient clinical conditions." The ACR Appropriateness Criteria Task Force was developed to create these guidelines.1 Its chair oversees 10 consensus panels, organized along organ lines, with eight diagnostic and two therapeutic committees. The panels develop guidelines using the eight attributes recommended by the Agency for Healthcare Policy and Research (AHRQ of Rockville, Md): validity, reliability/reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process, scheduled review, and documentation. These guidelines are reviewed every three years. Each panel identifies clinical conditions and specific questions that address variants, conducts literature searches of peer-reviewed journals, develops evidence tables using the relevant articles, and achieves an 80% consensus with a modified delphi technique. (This method uses serial surveys to consolidate expert opinions with a 1–9 scoring system and a maximum of three rounds.) The results are meant to apply to the majority of patients with adjustments to suit the complexity and severity of the condition, as well as the availability of equipment and trained personnel. The following are the task force panels: Cardiovascular imaging Gastrointestinal imaging Interventional radiology Musculoskeletal imaging Neurologic imaging Thoracic imaging Urologic imaging Pediatric imaging Radiation oncology-bone metastases Radiation oncology-brain work group Radiation oncology-breast work group Radiation oncology-Hodgkin's work group Radiation oncology-lung work group Radiation oncology-prostate work group Radiation oncology-rectal/anal work group Women's imaging Women's imaging-breast work group The ACR recently announced a collaboration with United Health Group (Minnetonka, Minn) to advance this effort, which is expected to offer improved diagnostic imaging services, informed consumer choice, and more affordable services through the elimination of unnecessary and suboptimal radiological testing. It is also expected to result in expanded use of the ACR's accreditation programs. More information, including the guidelines, can be found online at www.acr.org. -RD Reference: American College of Radiology. ACR Appropriateness Criteria. Available at: http://www.acr.org/s_acr/sec.asp?CID=1847&DID=16052. Accessed December 13, 2004.

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