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Background We compared the performance, confidence, and response consistency of five chatbots powered by large language models in solving European Diploma in Radiology (EDiR) text-based multiple-response questions. Methods ChatGPT-4o, ChatGPT-4o-mini, Copilot, Gemini, and Claude 3.5 Sonnet were tested using 52 text-based multiple-response questions from two previous EDiR sessions in two iterations. Chatbots were prompted to evaluate each answer as correct or incorrect and grade its confidence level on a scale of 0 (not confident at all) to 10 (most confident). Scores per question were calculated using a weighted formula that accounted for correct and incorrect answers (range 0.0–1.0). Results Claude 3.5 Sonnet achieved the highest score per question (0.84 ± 0.26, mean ± standard deviation) compared to ChatGPT-4o (0.76 ± 0.31), ChatGPT-4o-mini (0.64 ± 0.35), Copilot (0.62 ± 0.37), and Gemini (0.54 ± 0.39) ( p  < 0.001). A self-reported confidence in answering the questions was 9.0 ± 0.9 for Claude 3.5 Sonnet followed by ChatGPT-4o (8.7 ± 1.1), compared to ChatGPT-4o-mini (8.2 ± 1.3), Copilot (8.2 ± 2.2), and Gemini (8.2 ± 1.6, p  < 0.001). Claude 3.5 Sonnet demonstrated superior consistency, changing responses in 5.4% of cases between the two iterations, compared to ChatGPT-4o (6.5%), ChatGPT-4o-mini (8.8%), Copilot (13.8%), and Gemini (18.5%). All chatbots outperformed human candidates from previous EDiR sessions, achieving a passing grade from this part of the examination. Conclusion Claude 3.5 Sonnet exhibited superior accuracy, confidence, and consistency, with ChatGPT-4o performing nearly as well. The variation in performance among the evaluated models was substantial. Relevance statement Variation in performance, consistency, and confidence among chatbots in solving EDiR test-based questions highlights the need for cautious deployment, particularly in high-stakes clinical and educational settings. Key Points Claude 3.5 Sonnet outperformed other chatbots in accuracy and response consistency. ChatGPT-4o ranked second, showing strong but slightly less reliable performance. All chatbots surpassed EDiR candidates in text-based EDiR questions. Graphical Abstract

BackgroundEmergency radiology (ER) is an important part of radiology. But what exactly is ER? How can the required competencies be acquired in a good and feasible way? Who should be in charge of this?ObjectivesDiscussion of ER contents and suggestions for the improvement of the acquisition of respective competencies during radiology training.Materials and methodsGeneral literature review, in particular the current German blueprint for medical specialist training regulations (Weiterbildungsordnung, WBO 2020), publications by the German Radiological Society (DRG), the European Society of Radiology (ESR), the European Society of Emergency Radiology (ESER) and the American Society of Emergency Radiology (ASER).Results and conclusionsAs proof of competence in ER in Germany, confirmation from the authorised residency training supervisor as to whether there is ‘competence to act’ either ‘independently’ or ‘under supervision’ in the case of ‘radiology in an emergency situation …, e.g. in the case of polytrauma, stroke, intensive care patients’ is sufficient. The ESER refers to all acute emergencies with clinical constellations requiring an immediate diagnosis 24/7 and, if necessary, acute therapy. The ESER and ASER offer, among other things, practical fellowships in specialised institutions, while the ESER complements this with a European Diploma in Emergency Radiology (EDER). On a national level, it would be advisable to use existing definitions, offers and concepts, from the ESR, ESER and ASER. Specialised institutions could support the acquisition of ER competencies with fellowships. For Germany, it seems sensible to set up a separate working group (Arbeitsgemeinschaft, AG) on ER within the DRG in order to drive the corresponding further ER development.

BackgroundTo provide an overview of existing Subspecialty Exams and Diplomas in Radiology and their endorsement as well as to providing an insight into the status of subspecialisation in radiology in Europe. The European Training Curriculum for Subspecialisation in Radiology mentions thirteen fields of subspecialisation within radiology. The websites of the corresponding subspecialty societies were checked for Subspecialty Exams and Diplomas. In addition, we performed a survey among European radiologists regarding subspecialisation in radiology.ResultsTen out of 13 European subspecialty societies offer a European subspecialty diploma. At least 7 out of the 10 European subspecialties societies in radiology offering a European subspecialty diploma obtained European Society of Radiology (ESR) endorsement. Two out of 10 obtained European Union of Medical Specialists—Council of European Specialist Medical Assessment endorsement. Survey among European radiologists who were ESR full members in March 2021 demonstrated that almost 20% of respondents indicated that they have no subspecialisation. Another 15% indicated that their area of subspecialisation is not recognised in their country of work. Eighty-four percent of respondents would like their area of subspecialisation in radiology to be officially recognised. According to the respondents, the major benefit of having their subspecialisation in radiology officially recognised is personal interest (45%).ConclusionsThere is a desire for more subspecialty recognition in radiology among European radiologists. Therefore, European subspecialty diplomas in radiology fulfil a need. Furthermore, there is room for further harmonisation and implementation on a European level regarding subspecialty training and recognition in radiology.Critical relevance statementAs there is a desire for more subspecialty recognition in radiology among European radiologists, European subspecialty diplomas in radiology fulfil a need and there is still room for further harmonisation and implementation on a European level regarding subspecialty training in radiology.Key points• Radiology has 13 subspecialties as per the European Training Curriculum for Subspecialisation.• Currently, 15 subspecialty diplomas are offered by European subspecialty societies in radiology• Members of the European Society of Radiology seek greater recognition of radiology subspecialties.

Objectives To assess the status of radiology subspecialisation recognition across Europe, targeting European Society of Radiology (ESR) National Societies. Methods A questionnaire was distributed to members of the ESR National Societies Committee regarding the recognition of radiology subspecialties in their respective countries. Results Responses were received from 37 out of 47 countries (78%). Radiology subspecialties are recognised in 25 countries, whereas in 12 countries, they are not. Among 12 countries without recognised subspecialisations, 9 expressed a desire for future recognition. There are large variations between countries regarding the number of officially recognised subspecialities, ranging from 0 to 12. Conclusion Based on responses from ESR National Societies Committee members, radiology subspecialties are recognised in 25 countries, while 12 countries do not have formal recognition. The majority of countries without recognised subspecialisations express interest in having them acknowledged in the future. Critical relevance statement This follow-up survey among ESR National Societies presents the recognition status of radiology subspecialisations in Europe. Among the 37 responding countries, there are significant variations in the number of officially recognised subspecialties, ranging from 0 to 12. Key Points Among the 37 ESR National Societies responding countries, between 0 and 12 out of 13 radiology subspecialties are recognised. No country recognises all subspecialties. The majority of countries without recognised subspecialisations would like them to be acknowledged.