A Minimal Shortcut Set for Your First On-Call Shift

The list of things to prepare before your first radiology on-call shift can grow quickly: review emergency findings, learn the department’s communication workflow, become familiar with the reporting system, and know when to contact a senior resident or attending radiologist. Adding hundreds of shortcuts to that preparation often creates more burden than benefit.

The ideal library for a first call is not large. It should be small, predictable, and easy to verify.

The purpose of this article is not to provide diagnostic sentences for particular diseases. It is to help you choose safe shortcut categories that reduce repeated writing tasks during a shift.

Order of priorities: safety, systematic review, speed

The order of priorities should not change when you use shortcuts:

1. Review the images systematically.
2. Recognize critical findings and communicate them to the appropriate person.
3. Write a clear report that answers the clinical question.
4. Reduce repetitive typing with shortcuts.

A shortcut supports the fourth step. It does not replace the first three.

How many shortcuts should be in your first-call set?

For most users, 10–15 active shortcuts are enough to begin. This number allows you to genuinely remember the codes and verify each expansion.

Your full library may contain hundreds of ready-made phrases, but the “active call set” should be a small favorites group containing only entries you are likely to use that night.

Category 1: Normal or limited-evaluation phrases

Normal statements are common in emergency examinations, but automatically inserting a complete normal template is risky. Instead, choose short, verifiable sentences for a single organ or structure.

Your active set might include building blocks such as:

• A normal-appearance sentence for a particular organ
• A short, context-specific sentence stating that no obvious acute abnormality is identified
• A phrase stating that evaluation is limited for technical reasons

The “limited evaluation” phrase is especially important. If motion, artifact, a noncontrast technique, or an inappropriate phase prevents the clinical question from being answered, the report should state that limitation clearly.

Category 2: Finding frameworks with measurement and laterality

Rather than inserting a complete diagnostic sentence automatically for common on-call findings, use a morphologic description framework:

At the level of the [side/region], a [lesion/finding] measuring [size] and demonstrating [key imaging features] is identified.

This structure requires the user to complete the side, size, and key features deliberately. Blank fields in the expanded text should be highly visible.

Two or three such frameworks are enough for a first-call set:

• Focal lesion description
• Collection/fluid description
• Calculus or calcific-density description

Write the clinical interpretation and degree of certainty separately according to the images.

Category 3: Comparison phrases

Comparison with prior imaging can be important in on-call reports. Phrases such as “stable” or “progression” should be used only after a genuine comparison has been performed.

Two short shortcuts are enough:

• An editable phrase stating that there is no meaningful change in size or appearance
• A phrase with a date field stating that a finding has increased or decreased compared with a prior study

Always verify the date, measurements, and differences in technique. When comparing measurements across modalities, choose a degree of certainty that reflects the limitations of the comparison.

Category 4: Recommendation and correlation phrases

It is easy to recommend further imaging in an on-call report; it is harder to justify it well. Instead of keeping many recommendation shortcuts in your minimal set, include a few general, editable structures:

• Clinical/laboratory correlation
• Further evaluation with an appropriate modality
• Date or condition fields for short-term or elective follow-up

Ask the following questions for every recommendation:

• Will the recommendation genuinely answer the clinical question?
• Is it urgent or elective?
• Do prior studies or the patient’s history change the recommendation?
• Is there a contraindication or a risk of unnecessary repeat imaging?

The shortcut inserts the sentence. It does not decide whether the recommendation is necessary.

Category 5: A non-personal communication-record framework

Communication of critical or unexpected findings should follow departmental and institutional policy. Your shortcut should not contain a fixed personal name. Use a fillable framework instead:

The findings were communicated to [person/role contacted] on [date and time].

Complete this field only after communication has actually occurred. The presence of the sentence in the report does not mean that communication took place.

Category 6: Simple impression-section starters

Instead of long, automatic impression paragraphs, choose small building blocks that help you summarize findings briefly and in order of priority.

For example:

• “Priority finding:”
• “With regard to acute abnormality:”
• “Compared with the prior examination:”

These starters do not generate clinical content on their own. They organize the impression and can help place the most important finding first.

What should not be included in a first-call set?

Fully automated “normal examination” reports

Using a complete normal template before genuinely evaluating every portion of the examination increases the risk of leaving behind a sentence that was not assessed or that conflicts with the case.

Long diagnostic paragraphs for rare diseases

Rarely used codes are hard to remember and may increase the degree of certainty unnecessarily. It is better to keep them in the searchable library for use when needed.

Fixed patient, physician, or institutional information

Do not include personal data in shortcuts. Complete names and communication fields deliberately at each use.

Further-imaging recommendations used without review

Recommending the same modality for every indeterminate finding is not good reporting. Do not let a recommendation sentence replace clinical judgment.

A 20-minute setup before the shift

First 5 minutes: Choose the context

Identify the modalities and examination types you are most likely to report that night. Review the report templates already used by your institution.

Second 5 minutes: Select 10–15 shortcuts

Add only phrases that fit the categories above to your favorites from the ready-made library.

Third 5 minutes: Test them

Expand every shortcut in an empty text field. Check special characters, punctuation, line breaks, and behavior inside the reporting screen.

Final 5 minutes: Perform a safety review

For each shortcut, identify:

• Which word must always be edited?
• Is there a measurement field?
• Is there a laterality field?
• Does it include a recommendation or degree of certainty?
• Could it trigger accidentally?

The rule for using shortcuts during call

Create a simple routine:

Trigger the shortcut → read the expanded text → complete variables → verify against the images → read again at the end of the report

Do not skip the second or final reading as you become faster. Familiarity with a shortcut does not mean that the sentence is correct for the current case.

A five-minute review after the shift

At the end of the shift, create three lists:

• Shortcuts I used frequently
• Phrases I searched for but could not find
• Shortcuts that worked incorrectly or slowly

Update your set before the next shift using only these real-use observations. This allows the library to develop from your workflow rather than from assumptions.

Build a minimal set with RadPhrases

Search the organ, status, and recommendation codes in the RadPhrases Shortcut Guide. Organize your first-call favorites as a small group.

To test them inside your actual reporting screen, download RadPhrases. Test new shortcuts before a busy on-call shift, and verify every expanded phrase clinically.

Clinical safety note

This content is a general workflow suggestion for on-call preparation. Your institution’s policies for critical-result communication, preliminary reports, attending supervision, and escalation take priority. Clinical decisions must be made by the responsible radiologist.

Sources

• American College of Radiology, “Practice Parameter for Communication of Diagnostic Imaging Findings”: Source (opens in a new tab)
• RSNA, “Re-envisioning On-call Resident Workflows”: Source (opens in a new tab)