Bridging the Gap in Undergraduate Radiology Education: A Literature Review and Prospective Evaluation of Case-Based Teaching.

Background Radiology is fundamental to modern medicine, yet undergraduate exposure remains variable. Inconsistent curricula and reliance on traditional lectures risk leaving graduates underprepared to interpret imaging, make appropriate requests, and integrate radiology into patient care. This study aimed to review published undergraduate radiology curricula and teaching methods in the UK and internationally, explore Year 3 medical students' understanding and perceptions following pilot radiology teaching sessions at the University of Manchester, and propose level-appropriate curriculum suggestions to address gaps. Methods A structured literature review was conducted across PubMed, Embase, and Google Scholar (2000-2025), encompassing studies that described undergraduate radiology curricula, teaching modalities, and assessment strategies. A prospective educational intervention was delivered to Year 3 medical students covering chest radiographs, CT head scans, imaging request justification, and imaging safety. Pre- and post-session surveys assessed confidence, knowledge of imaging safety, and radiology perceptions, alongside prior exposure to radiology teaching. Paired comparisons were analysed using paired t-tests and free-text responses underwent thematic analysis. Results UK and European consensus curricula emphasise core competencies for undergraduate radiology, including interpretation of common imaging (chest X-ray, acute CT head), safe imaging practices, and effective communication of findings. Delivery is inconsistent across schools; foundation doctors are expected to request appropriate investigations and integrate imaging into clinical care. Twenty-eight students attended the pilot radiology teaching sessions, of whom 26 completed paired pre- and post-session surveys and comprised the analytic sample (response rate 92.9%). Most Year 3 students reported limited prior radiology teaching, variable understanding of the speciality, and underestimation of radiology's role within the NHS. Mean self-reported confidence in chest radiograph interpretation increased from 3.1 ± 1.4 to 7.6 ± 1.2 (mean difference 4.5, 95% CI 3.9-5.1; p < 0.001). Confidence in acute CT head interpretation increased from 2.8 ± 1.3 to 7.2 ± 1.1 (mean difference 4.4, 95% CI 3.8-5.0; p < 0.001). Awareness of radiation dose differences improved from 38% to 81%. Most students reported limited prior radiology teaching, while 88% preferred case-based teaching and 85% supported earlier, clinically integrated radiology exposure in the curriculum. Conclusion Undergraduate radiology education remains heterogeneous and often insufficient to meet early postgraduate expectations. Evidence supports case-based, interactive approaches that align with clinical practice. To bridge this gap, our findings highlight a need for a structured, competency-based radiology curriculum in UK medical schools, with emphasis on early exposure, integration with clinical placements, and multimodal teaching.