We have a problem!

We have achieved many of the objectives that we set out to achieve: The journal now comes out on time. There is a defined structure. We have been successful, at least partly, in discouraging and thereby reducing the number of case reports. We now have regular features, pictorial essays, reviews, and editorials. 
 
But we still lack original clinical research and outcome papers. Such articles make up less than 5% of the papers received; 75% of submissions are still case reports. 
 
It is not enough for the journal to serve as a continuing medical education (CME) tool. It also needs to showcase the practice patterns and the clinical research being done in radiology in this country. 
 
The majority of the clinical research articles that we get are converted theses. These are usually badly written, with no understanding of statistics and no statistical relevance. They may get accepted by the Universities and by the National Board of Examinations, but that does not necessarily mean that these theses meet the journal's standards. 
 
It is a chicken-and-egg situation. Since we are not indexed, good researchers do not want to send articles to the journal; and until we get more such articles, it is unlikely that we will get indexed. 
 
Nevertheless, we need to find a solution and I solicit your suggestions and advise. Please email me at editor@ijri.org. 
 
 
Some possible suggestions are: 
 
 
All heads of departments need to constructively push their residents into planning clinical studies and writing them up. There is significant material available in this country. 
 
 
The IJRI should try and hold ‘writing’ courses. 
 
 
All studies presented in the annual conference may be fast-tracked. 
 
 
 
 
This issue starts off with a symposium on obstetric USG that has been guest edited by Dr Ramamurthy and Dr Gune. There will be more articles on the same subject in the February 2009 issue, to be followed by a symposium on breast imaging in the May and August 2009 issues. 
 
Dr N. Khandelwal's oration from 2008 on ‘CT Perfusion in Stroke’ has been published in this issue. Dr V. Rangarajan gives us his perspective on the current status and growth of PET/CT in India. We have reproduced two articles by Dr K. P. Mody, from the IJR issues of the mid-50s, on radiology teaching and curriculum and ethics; they are relevant even today. 
 
The response to the last issue's editorial has been quite heartening. One interesting quote: ‘Residents hardly take on any responsibilities. All the major decisions are taken by consultants. PGs are more or less doing an ‘observership’ kind of posting-which is extremely sad. As a result, we are churning out a bunch of spineless, gutless radiologists who need to spend at least 3 more years in a decent place to expose them to the real big bad world of radiology.’ It is quite clear on talking to a cross-section of teachers in the country that the current batch of residents and newly-minted radiologists are quite poorly trained, with no perspective on the clinical relevance of the various examinations. Most seem only interested in capitalizing on their education and maximizing their ‘earning’ potential, even if it is at the cost of their own growth. We need to remember that, unlike in other professions, radiologists tend to work till the ages of 70 and beyond, and we cannot sacrifice long-term benefits for the short-term. 
 
In a subsequent editorial, I will show how even from an ‘earnings’ perspective a radiologist does much better than most MBAs when we compare apples to apples and oranges to oranges.

Today's case study: selecting a ski resort for a vacation trip with friends ▪ You are thinking to go to a ski resort with six other friends for the January holidays ▪ Your group consists of people of different affluence, but it would be better to find an option which all of them could afford ▪ All participants agree that an optimal duration of the trip would be 5-7 days ▪ One of the participants has had a vacation in Italy a few times, so this year, he would like to go elsewhere.
▪ Selection of a right resort to go to is important for all group members except Alex who is ready to go anywhere for company's sake ▪ The group includes a young couple with a child, and they would like to have a good selection of slopes suitable for entry-level skiers and families with children.
▪ The choice has to be made within the next 2 weeks, otherwise Serge, Chris, and Kate will change their minds and will go to Bali, which will cancel the entire trip. 8 Exercise. Select the best wording Where could we go for vacation?
My friends and I plan to go skiing together and need to organize the trip Where can we go skiing in January?

Problem definition
Which ski resort to select for a 5-7 days vacation trip during the January holidays based on the requirements of six friends out of seven? It is easy to build the correct structure by using a special methodthe MECE principle 2 As a result, we get a lean and logical structure which comprises all required components without any "frills"

Mutually Exclusive, Collectively Exhaustive MECE
The MECE principle helps to ▪ better understand the task ▪ break it down into components ▪ avoid leaving out essential things Meeting the MECE principle assures complete coverage of the subject matter without duplicating its elements ? Mutually exclusive elements: the structure must have no repetitions Collectively exhaustive elements: no element must be left out 2 13 Some MECE-based structuring methods 2 Examples ▪ Profit = income itemsexpense items ▪ Profit = market volume x market share x profitability ▪ Profit = profit from region 1 + profit from region 2 + ... ▪ Profit = profit from product 1 + profit from product 2 + ...

Mathematical formula
▪ Profit and loss statement ▪ Organizational structure of a company ▪ Budget of an organization ▪ Product mix Generally accepted structure ▪ Efficiency of an employee depends on whether he or she has requisite knowledge and skills, on degree of his or her motivation, and on the incentives system implemented by the organization ▪ Personal tasks need to be prioritized based on their importance and urgency

Logical statement
Decision tree exampleis it MECE?
Are we going to like that ski resort?
How much is the ski pass and equipment rental?
How much is lodging?
How much will meals cost?
Are airline tickets available?
Is it still possible to book hotel rooms?
Is it easy to get to the resort from the airport?
How much is the airfare?
Will there be snow on the slopes during our stay?
Are there enough pistes of various degree of difficulty on the slopes?
Is there a convenient skier transportation infrastructure on the slopes? How extensive are the options for spending leisure time after skiing?
How attractive is the town in which we will be staying?
How much is a hotel room per night?
How much does it cost to eat out?
Is it possible to find affordable lodging?
Is there an option to buy food in supermarkets?
What bars and clubs are available at the resort?
Are there any entertainment facilities at the resort (e.g., waterparks)?
Are there facilities with interesting after-ski programs on the slopes? Are there interesting sights or cultural landmarks in town?
Are there beautiful places in town to take a walk around?
Does the resort have a good infrastructure?
Will we be able to make it to the resort?
How interesting and comfortable will be our time at that resort? Are we going to like that ski resort?
How much is the ski pass and equipment rental?
How much is lodging?
How much will meals cost?
Are airline tickets available?
Is it still possible to book hotel rooms?
Is it easy to get to the resort from the airport?
How much is the airfare?
Will there be snow on the slopes during our stay?
Are there enough pistes of various degree of difficulty on the slopes?
Is there a convenient skier transportation infrastructure on the slopes?
How extensive are the options for spending leisure time after skiing?
How attractive is the town in which we will be staying?
How much is a hotel room per night?
How much does it cost to eat out?
Is it possible to find affordable lodging?
Is there an option to buy food in supermarkets?
What bars and clubs are available at the resort?
Are there any entertainment facilities at the resort (e.g., waterparks)?
Are there facilities with interesting after-ski programs on the slopes?
Are there interesting sights or cultural landmarks in town?
Are there beautiful places in town to take a walk around?
Does the resort have a good infrastructure?
Will we be able to make it to the resort?
How interesting and comfortable will be our time at that resort?
How much will the trip cost?
3 Priority area Are we going to like that ski resort?
How much is the ski pass and equipment rental?
How much is lodging?
How much will meals cost?
Are airline tickets available?
Is it still possible to book hotel rooms?
Is it easy to get to the resort from the airport?
How much is the airfare?
Will there be snow on the slopes during our stay?
Are there enough pistes of various degree of difficulty on the slopes?
Is there a convenient skier transportation infrastructure on the slopes?
How extensive are the options for spending leisure time after skiing?
How attractive is the town in which we will be staying?
How much is a hotel room per night?
How much does it cost to eat out?
Is it possible to find affordable lodging?
Is there an option to buy food in supermarkets?
What bars and clubs are available at the resort?
Are there any entertainment facilities at the resort (e.g., waterparks)?
Are there facilities with interesting after-ski programs on the slopes?
Are there interesting sights or cultural landmarks in town?
Are there beautiful places in town to take a walk around?
Does the resort have a good infrastructure?
Will we be able to make it to the resort?
How interesting and comfortable will be our time at that resort?
How much will the trip cost?

CASE INTRODUCTION
Your team has received a proposal to develop a design for a group of Russian investors who want to build Hyperloop in Russia.
We need to substantiate whether this project is feasible.

Case study
Requirements ▪ No more than 6 slides besides the title slide and team introduction ▪ All additional analytics and calculations can be backed up in the presentation ▪ You will have 10 min for presentation and 10 min for Q&A