We describe a 1-year remedial program for radiology residents with deficiencies in basic medical sciences that cause difficulty in the understanding and application of basic radiologic principles. Six of 107 residents participated in the remedial program at separate times during an 8-year period. The design of the remedial program was based on the following: 1) reassignment to first year basic radiology rotations with 1-year delayed advancement to the subspecialty rotations; 2) comprehensive radiology texts that contain a detailed review of related embryology, anatomy, physiology and pathology; 3) instruction in the study of the texts; and 4) repetitive learning accomplished by intermittent reassignment of rotations in which difficulty was demonstrated. Resident performance was evaluated by correlation of monthly written faculty evaluations, the results of the American College of Radiology Intraining Examination, and the American Board of Radiology (ABR) written and oral examinations. During the period of remediation, faculty evaluation revealed improved performance in all six residents from below-average ratings (mean = 2.3) to above-average and superior ratings (mean = 8.3). These results were correlated with the American College of Radiology Intraining Examination scores, which improved from the lowest quartile (range 0% to 28%) to the highest (range 78% to 99%). Each resident successfully passed the ABR written and oral boards on the first attempt. Two additional residents who were offered but did not accept remediation eventually dropped out of the program or repeatedly failed the written ABR examination. Ultimately, strengthening basic medical science knowledge facilitated interpretation of radiographs by enabling the integration of basic radiologic and scientific principles and understanding the underlying basic medical, radiologic, and clinical significance.