From Knowing MRI to Doing MRI: Why Our Graduates Are Underprepared for Clinical Practice
Abstract
Purpose
Traditional MRI education emphasizes physics knowledge, lectures, and artifact recognition, but often does not produce graduates who can function independently in clinical practice. We aim to define core MRI competencies for graduating medical physicists and demonstrate how Entrustable Professional Activities (EPAs) can bridge the gap between physics knowledge and clinical competence, ensuring that theoretical understanding translates into safe, effective clinical performance.
Methods
We identified clinically relevant tasks that medical physics trainees (graduates and residents) must perform independently, including: optimizing sequences to reduce motion and artifacts, explaining SAR tradeoffs and safety considerations to clinicians, debugging artifacts in clinical MRI, and communicating technical limitations to radiologists. The scope was extended to specialized applications such as time-of-flight (TOF) effects in MRA, diffusion imaging, perfusion MRI, and functional MRI (fMRI), with attention to sequence-specific tradeoffs, signal-to-noise optimization, and artifact mitigation. These competencies were structured into measurable outcomes to guide curriculum design and trainee assessment in graduate and residency programs, explicitly linking physics knowledge to clinical tasks.
Results
A competency-based framework clarifies what a graduating physicist should be able to do, rather than just what they know. Mapping clinical expectations to measurable tasks across conventional and advanced MRI applications enables educators to: 1) Target instruction to skills that directly translate physics knowledge into clinical competence; 2) Assess trainees using objective, observable outcomes; 3) Enable independent problem-solving across a range of MRI modalities; 4) Communicate technical limitations effectively to clinical teams.
Conclusion
Shifting MRI education from knowledge-focused training to competency-based clinical readiness bridges the gap between physics knowledge and clinical competence, preparing graduates to function safely and independently across the full spectrum of MRI applications. Applying EPAs to conventional and advanced modalities equips programs to produce trainees who are clinically capable, and confident, ultimately enhancing patient care and supporting collaborative practice with radiologists and clinicians.