AI and Radiology Residency: What Program Directors Should Keep in Mind
What You'll Learn
This guide teaches one core skill you can apply in many different ways: how to collaborate with AI as a thinking partner, not just a task executor. By the end, you'll understand:
- The difference between using AI as a tool vs. collaborating with AI
- Nine specific techniques across three levels of collaboration
- How to move from "co-thinking" (conversation) to "co-working" (autonomous tasks)
- Practical how-to guides for Claude, ChatGPT, and Google AI tools
AI is powerful, but you bring irreplaceable expertise: clinical judgment, institutional knowledge, relationships with residents, and understanding of your program's unique context. The goal isn't to hand over decisions to AI—it's to amplify your effectiveness. You remain the "human in the loop" (a term popularized by Ethan Mollick) who guides, validates, and makes final calls.
From Tool to Collaborator
The way we think about AI is shifting fundamentally. Understanding this shift is the foundation for everything else.
A concept articulated by Jeremy Utley (Stanford d.school): AI functions best not as an answer machine but as a thinking companion. A strategic thought partner engages with you across every phase of a project—planning, research, discussion, creation, and feedback—helping you think better rather than thinking for you.
Co-Thinking
Co-thinking is interactive collaboration—you and AI working together through conversation. The three levels below (Capture, Challenge, Coach) represent increasing depth of collaboration, from you leading the process to AI guiding it.
At this level, you're firmly in control. You have ideas, tasks, or information—AI helps you capture, organize, and transform them. This is where most people start, and it's immediately useful.
1. Voice Dictation
Speak your thoughts naturally and let AI transcribe, organize, and respond.
Why it matters: When you speak instead of type, ideas flow more freely. Typing naturally triggers self-editing—you stop to fix phrasing, second-guess word choices, and lose momentum. Dictating bypasses that filter, letting your thoughts come out in a raw, uninterrupted stream that AI can then help you organize and refine.
2. Second Brain
Create a persistent knowledge repository that AI can reference across conversations.
Upload documents, past decisions, policies, and context—then have AI help you make connections and retrieve relevant information.
A second brain is an external system that stores your knowledge, ideas, and reference materials in a way that's searchable and connectable. With AI, this becomes interactive—you can ask questions of your accumulated knowledge, not just search it. The term was popularized by Tiago Forte.
For Program Directors: Imagine uploading your program's policies, past CCC notes, accreditation documents, and curriculum outlines. Then asking: "Given our history with milestone assessments, what should we consider when implementing the new EPA framework?"
3. Output Formats
Transform your thinking into different formats without starting from scratch each time.
The same core content can become an email, slide deck, handout, FAQ, or even a script. AI handles the reformatting while you focus on the substance.
At this level, AI becomes an active thinking partner. Instead of just capturing and transforming your ideas, it challenges them, offers alternatives, and helps you see blind spots.
1. Non-Obvious Solutions
Explicitly ask AI to go beyond the obvious and explore less traveled paths.
When you present a problem, AI's first suggestion is often conventional. Push it to explore alternatives you haven't considered.
Why this works: AI has absorbed countless approaches to common problems. By asking it to distinguish obvious from non-obvious, you filter for insights that are actually new to you.
2. Sparring Partner
Ask AI to argue against your position to stress-test your thinking.
This isn't about AI being right—it's about stress-testing your thinking before you commit to a decision or communicate it to others.
3. Expand the Team
Introduce AI into team discussions and departmental workflows to multiply impact.
AI collaboration works best when shared with colleagues.
How to use this: Bring AI into your next faculty meeting or committee discussion. Use it live to capture ideas, synthesize different viewpoints, or draft action items in real time. Share a project workspace with colleagues so everyone can contribute context and benefit from the same AI-assisted analysis.
Key benefit: When teams use AI together, they build shared mental models for what works. One person's prompting technique becomes everyone's. Collective learning accelerates individual adoption.
At this advanced level, you flip the dynamic: instead of you driving the conversation, AI guides you through a structured process. This is powerful when you're stuck, unclear on what you need, or facing a complex problem.
1. Planning Mode
Let AI structure a project before you dive into execution.
Describe what you want to accomplish; AI creates a plan, timeline, and identifies potential obstacles.
The power of "don't start yet": By explicitly asking AI to plan before executing, you get a roadmap you can review and adjust rather than outputs you have to redo.
2. Iterative Research
Have AI self-evaluate its output and improve through testing and iteration.
Instead of accepting AI's first output, create an iterative improvement cycle where AI reviews its own work, identifies gaps, and refines the result. This mirrors the scientific method: generate, test, improve, repeat.
How this works: After AI produces initial research or analysis, ask it to read what it created, identify what questions or concerns the output raises, gather additional information to address those gaps, and then incorporate the new insights into an improved version.
Why this matters: AI's first attempt is often surface-level. By building in self-evaluation and iteration, you get deeper, more nuanced outputs that anticipate follow-up questions and address weak points before you even ask.
3. Coaching Questions
Ask AI to interview you rather than waiting for your instructions.
This is especially useful when you know you have a problem but haven't crystallized what you need.
Structured questions that help you articulate fuzzy goals. Instead of you trying to explain what you want, AI guides you through questions that surface what you actually need. Particularly powerful for complex challenges where the problem definition isn't clear.
The Four Roles AI Can Play
As you use the co-thinking techniques in Capture, Challenge, and Coach, AI can also be thought of as taking on different roles.
Strategist
Helps you see the big picture, identify priorities, and plan approaches
Critic
Challenges your thinking, finds weaknesses, and stress-tests ideas
Planner
Breaks down projects, creates timelines, and organizes tasks
Builder
Creates drafts, generates content, and produces deliverables
(Pro tip: You can even explicitly ask AI to take on these roles for emphasis.)
Every Phase of Your Work
Use AI throughout a project lifecycle—not just at specific moments. Planning, research, discussion, creation, feedback and testing.
Co-Working
Co-working is what happens when AI moves beyond conversation to actually doing work alongside you—autonomously executing tasks while you focus on higher-level guidance.
Currently available examples: Claude Cowork and Google Antigravity are early implementations of this co-working paradigm, allowing AI to work on tasks autonomously while you focus elsewhere.
"Vibe coding" is a term for describing what you want built rather than how to build it. You specify the outcome; AI handles the implementation. This extends beyond code: you can "vibe" your way to slide decks, research summaries, data analyses—any complex output where you know the goal but not every step.
The Inbox Future
The future of AI work isn't a chat window you stare at. It's an inbox you check.
You tell a team of AI agents what you want and provide ways for them to grade their work as successful. You don't need to tell them how. They work autonomously and report back when they're done or need input.
From Chat Box to Inbox
Imagine this workflow: You open your AI dashboard in the morning. Several tasks are in progress—a research summary on new ACGME requirements, a draft schedule optimization, talking points for the faculty meeting. You didn't watch any of these happen. You review the outputs, provide feedback or approve, and queue up new tasks.
For radiology: A few cases opened, each being worked on in parallel. You're not waiting and watching. You're managing a portfolio of AI-assisted work, checking in when outputs are ready.
Today
Interactive chat—your attention required
Emerging
Autonomous tasks—check back later
Future
Many agents working simultaneously — Agents check in via Inbox
What About Resident Training?
If AI handles low-level work, how do residents develop foundational skills? This question doesn't have easy answers, but it needs active engagement.
Expertise Through Repetition
Residency has historically relied on repetition of fundamental tasks to build expertise. Reading hundreds of studies builds pattern recognition. Writing countless reports develops communication skills. Working through problems step-by-step creates problem-solving intuition.
If AI can generate preliminary reads, draft reports, and walk through differential diagnoses, what happens to this developmental process? Are we removing valuable struggle, or freeing residents to focus on higher-order skills sooner? We've navigated similar transitions before—dictation software, PACS, search engines, electronic records—and each time we adapted training. This may be different in scale, but perhaps not in kind.
Platform Quick-Start Guides
Specific instructions for getting started with the major AI platforms and their collaboration features.
Claude (Anthropic)
claude.ai
Claude Projects (Second Brain)
Projects let you create persistent workspaces with uploaded documents that Claude references across conversations.
Create a Project
Click "Projects" in the sidebar → "Create Project" → Name it (e.g., "Program Director Resources")
Add Knowledge
Upload PDFs, documents, or paste text into the project's "Knowledge" section. Claude references these in all conversations.
Set Custom Instructions
Add instructions that apply to all conversations (e.g., "You're helping a radiology program director. Always consider ACGME requirements.")
Extended Thinking (Reasoning Mode)
Claude can show its reasoning process for complex problems.
Enable Extended Thinking
Click the lightbulb icon or toggle "Extended thinking" before sending a complex query.
Review the Thinking
Claude shows a "Thinking..." section where you can see its reasoning before the final response.
Claude for Chrome (Browser Agent)
Claude can control a browser to navigate websites, fill forms, and complete web-based tasks.
Install Extension
Search "Claude for Chrome" in Chrome Web Store and install the official Anthropic extension.
Direct Browser Tasks
Ask Claude to "go to [website] and find [information]" or "fill out this form." Review actions before confirming.
ChatGPT (OpenAI)
chatgpt.com
ChatGPT Projects
Create workspaces with persistent files and custom instructions.
Create a Project
In the sidebar, click "Projects" → "New Project" → Name and describe your project.
Upload Files
Add documents to the project. ChatGPT uses these as context for all conversations.
Voice Conversations
Have natural spoken conversations using the mobile app or web interface.
Mobile App
Tap the headphone icon to start a voice conversation. Speak naturally; ChatGPT responds aloud.
Web Voice
Click the microphone icon to dictate. Click the speaker icon on responses to hear them read aloud.
Custom GPTs
Create specialized AI assistants with specific instructions and knowledge for recurring tasks.
Create a GPT
Click "Explore GPTs" → "Create" → Describe what you want your GPT to do.
Add Knowledge & Share
Upload documents in "Configure" tab. GPTs can be private, shared via link, or published publicly.
Google AI Tools
Gemini & NotebookLM
Google Gems (Custom Personas)
Gems are custom versions of Gemini with specific instructions for different use cases.
Access Gems
In Gemini (gemini.google.com), click "Gem manager" in the sidebar.
Create & Use
Click "New Gem" → Give it a name and detailed instructions → Select it from sidebar to use.
NotebookLM (Research Assistant)
Google's AI research tool that works only with sources you provide—no external training data mixed in.
Unlike general chatbots, NotebookLM only answers based on documents you upload. Excellent for research where you need AI to stay within specific sources without hallucinating from training data.
Create a Notebook
Go to notebooklm.google.com → "New Notebook" → Name your project.
Add Sources
Upload PDFs, paste text, add Google Docs, or link YouTube videos and websites.
Query & Generate
Ask questions of your sources. Generate study guides, FAQs, or audio overviews.
Browser Automation
AI-Controlled Web Navigation
Browser automation lets AI act as an autonomous agent that can navigate websites, "see" pages through screenshots, and click buttons to complete tasks on your behalf. These tools can research across multiple sites, fill out forms, and interact with web applications.
Available Tools
Claude for Chrome
Anthropic's browser extension lets Claude see your screen, navigate pages, and click elements to complete multi-step web tasks autonomously.
Gemini for Chrome
Google's extension enables Gemini to view and interact with web pages, taking screenshots to understand context and executing clicks and navigation.
Perplexity Browser Comet
Combines search with browser capabilities to research topics across the web, synthesizing information from multiple sources into coherent answers.
Start with a Problem. Try Co-Thinking.
It's a great time to start. You're not behind. It's exciting and easier than ever before.
Pick One Real Problem
Something you're actually working on this week. Not a test case—a genuine task where better thinking or faster execution would help.
Try One CAPTURE Technique
Voice dictation, second brain, or format transformation. Experience AI as capture tool before moving to collaboration.
Experiment with CHALLENGE
Ask AI to push back on something. Request non-obvious solutions. Have it play devil's advocate on a decision you're considering.
Let AI COACH You Once
For a complex problem, let AI ask you questions instead of the reverse. See what emerges when you're not driving.
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