Ask a radiology resident whatever

[bjb305]

I liked the neurosurg guy's idea (and slightly sorry for stealing it).. but I also wanted to get more people interested in radiology because it's freakin awesome.
So just a little background before the questions --- I did not consider radiology AT ALL before med school.. and didn't really consider it before 3rd year. I went into school thinking I would do either ER, trauma surg, plastic surg, neurosurg but never radiology. After starting 3rd year I slowly came to realize that radiology was right for me because I initially went into med school for the science. I wanted to learn everything about how the body worked and about diseases. And after first year, I knew I had to go into something that was very anatomy focused because that's what I love. And now that I'm sitting behind the computers in the dark room, I cannot possibly be happier.
So feel free to ask whatever and I'll try to check this most nights and answer any questions. Feel free to PM me also. And just a note --- radiology residency is basically 8-5 Mon-Fri. Weekends and holidays off unless you're on call which is typically 3-6 days per month depending on residency size.

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[Cyberdyne 101]

Thanks for doing this! I have a question:
What is an MRA? And why is it used to diagnose hip labral tears? Is this any different from an MRI that is used to identify ACL ruptures?

 

[chillaxbro]

MS1 interested in radiology (maybe)
I hear the job market is getting bad because we're getting outsourced. What's really happening? and what are your thoughts about that?
Is interventional radiology better? Would someone interested in rads be interested in IR or are they too different to really say?

 

[AndyQC]

MS1 interested in radiology (maybe)
I hear the job market is getting bad because we're getting outsourced. What's really happening? and what are your thoughts about that?
Is interventional radiology better? Would someone interested in rads be interested in IR or are they too different to really say?

I second this question.

 

[DrBowtie]

Thanks for doing this! I have a question:
What is an MRA? And why is it used to diagnose hip labral tears? Is this any different from an MRI that is used to identify ACL ruptures?

MRA in the way you are using it likely means MR Arthrogram where you do an MR after injecting contrast in a joint.

Traditional use of "MRA" means MR Angiography used to eval vessels, most commonly for the head and neck.

 

[Cyberdyne 101]

MRA in the way you are using it likely means MR Arthrogram where you do an MR after injecting contrast in a joint.

Traditional use of "MRA" means MR Angiography used to eval vessels, most commonly for the head and neck.

Ah, that makes sense! I was thinking of the angiography. That's why I was confused. Thanks!

 

[bjb305]

Thanks for doing this! I have a question:
What is an MRA? And why is it used to diagnose hip labral tears? Is this any different from an MRI that is used to identify ACL ruptures?

MRA = MR angiography or angiogram -- which is injecting contrast into veins.
For labral tears or other joint pathology you can do MRI after injecting contrast into the joint. This helps distend the joint capsule and give you better visualization of the labrum. This is typically done for shoulder or hip pathology.
ACL ruptures from what I've seen are typically just a standard MRI, they are larger than the labrum and easier to diagnose tears.

 

[bjb305]

MS1 interested in radiology (maybe)
I hear the job market is getting bad because we're getting outsourced. What's really happening? and what are your thoughts about that?
Is interventional radiology better? Would someone interested in rads be interested in IR or are they too different to really say?

Recently the job market has been bad because people aren't retiring. And since reimbursement has gone down some practices are just working longer to compensate for that to keep the same income instead of hiring new people. I can't say if IR is any different. And I'm not quite sure I understand the next question but most people in IR do a diagnostic radiology residency first and then the 1 year fellowship in IR afterwards. 3 of my senior residents are doing IR fellowships next year.
And as far as the job market for YOU guys -- if you haven't started med school yet, or you just did... you're talking about 10 years down the line.... and ANYTHING can change by then

 

[Symmetry11]

You mentioned that you went into "med school for the science" and that's why radiology was such a good fit. How does radiology teach you everything about the body and diseases? Do you have to be proficient in multiple organs systems anatomy and pathology?

 

[moisne]

I just want to say - radiology is pretty competitive - plenty of people are interested. But thanks for doing this.

 

[Styrene]

How much did you know about radiology on your first day of radiology residency?

What kind of research do radiologists do?

Have you ever seen a mandibular condyle dislocate into the middle cranial fossa?

To what degree is the process of identification of structures on complex scans its own pursuit? In other words, could you easily identify structures you see on scans within a corpse in the anatomy lab?

 

[amad01]

You mentioned that you went into "med school for the science" and that's why radiology was such a good fit. How does radiology teach you everything about the body and diseases? Do you have to be proficient in multiple organs systems anatomy and pathology?

really? Have you ever been around or shadowed or listened to a radiologist? They spit out anatomy at a million miles an hour into a little microphone without even having to think twice about it... yeah they're pretty proficient... I asked a radiologist I shadowed if he learned all the anatomy he needed to do his job in med school... he just laughed at me and said hell no.. went to a top20 school

 

[amad01]

I know a radiologist who has a dark room in his basement at his house and works from home when he's not at the clinic... is this common? My dream job...

 

[DrBowtie]

Do you have to be proficient in multiple organs systems anatomy and pathology?

Absolutely. You consult for every single specialty in the hospital.

 

[bjb305]

You mentioned that you went into "med school for the science" and that's why radiology was such a good fit. How does radiology teach you everything about the body and diseases? Do you have to be proficient in multiple organs systems anatomy and pathology?

you basically have to know a LOT of anatomy... more than what they teach you in med school.. plus a lot of syndromes that nobody has ever heard of. I find it very interestnig cause there are certain findings you see which make you hunt for other things associated with them. you also need to know about certain surgical procedures and what it looks like on CT/MRI afterwards

 

[bjb305]

How much did you know about radiology on your first day of radiology residency?

What kind of research do radiologists do?

Have you ever seen a mandibular condyle dislocate into the middle cranial fossa?

To what degree is the process of identification of structures on complex scans its own pursuit? In other words, could you easily identify structures you see on scans within a corpse in the anatomy lab?

I knew pretty much next to nothing except the anatomy on the first day.

All kinds of research -- can't really delve into that one as I've never done research yet (but will be next year)

mandibular condyle discolation -- nope.. on neuro next month tho

They aren't too hard to identify unless they have a mass lesion or have had prior surgery.. but some can still be tricky

 

[bjb305]

I know a radiologist who has a dark room in his basement at his house and works from home when he's not at the clinic... is this common? My dream job...

there are teleradiology firms that will set those up for you.. also depends on the practice.. i've heard of people in private groups that would get a home station because they lived 50+ miles away from the job

 

[NickNaylor]

How you feelin about that job outlook?

I worked with an attending whose husband is a radiologist, and she said it has been insanely difficult for him to find a new job. He's currently at a group, but is looking to move somewhere else. She said he's looked for months and has yet to get anything promising.

 

[EMDO2018]

you all can go ahead cut residency slots

 

[bjb305]

How you feelin about that job outlook?

I worked with an attending whose husband is a radiologist, and she said it has been insanely difficult for him to find a new job. He's currently at a group, but is looking to move somewhere else. She said he's looked for months and has yet to get anything promising.

Currently I'm not worried about it. I'm pretty sure I want to stay academic and either stay where I'm training or go back to where I did med school and I know some people in both locations so we'll just see what happens. I still have 5 years before I get my real job anyway

 

[DrBowtie]

How you feelin about that job outlook?

I worked with an attending whose husband is a radiologist, and she said it has been insanely difficult for him to find a new job. He's currently at a group, but is looking to move somewhere else. She said he's looked for months and has yet to get anything promising.

It's not great but all of the fellows from my program have gotten decent jobs.

Too many factors to discuss briefly but longevity of career, stock market, declining reimbursement and many poor training programs leading to supply mismatch.

There is ongoing consolidation into larger groups so cities are often dominated by 2-5 groups. Makes lateral moves somewhat difficult.

 

[NickNaylor]

It's not great but all of the fellows from my program have gotten decent jobs.

Too many factors to discuss briefly but longevity of career, stock market, declining reimbursement and many poor training programs leading to supply mismatch.

There is ongoing consolidation into larger groups so cities are often dominated by 2-5 groups. Makes lateral moves somewhat difficult.

Yeah, that seems to be the situation he's going through. Relatively small number of practices in the city, don't wanna go to the burbs, etc. etc.

 

[CherryRedDracul]

Do you have any recommendations for fantastic books or resources for medical students thinking of going into radiology? I'm starting my radiology elective next week.

 

[bjb305]

Do you have any recommendations for fantastic books or resources for medical students thinking of going into radiology? I'm starting my radiology elective next week.

i'm not really sure what to tell you here.. cause if you're thinking of going into radiology and haven't decided, i wouldn't necessarily say there's a book that can help you with that decision. and as far as resources for radiology -- i don't think any book would be appropriate for a med student since there's just way too much info to learn and it would be pointless for a med student to learn that.

 

[YoungProdigy]

Is it true that radiology mostly attracts introverts?

 

[DrBowtie]

Do you have any recommendations for fantastic books or resources for medical students thinking of going into radiology? I'm starting my radiology elective next week.

Learning Radiology by Herring is a great med student level book.

 

[DermViser]

Yeah, that seems to be the situation he's going through. Relatively small number of practices in the city, don't wanna go to the burbs, etc. etc.

What's wrong with living in suburbs?

 

[DermViser]

I liked the neurosurg guy's idea (and slightly sorry for stealing it).. but I also wanted to get more people interested in radiology because it's freakin awesome.
So just a little background before the questions --- I did not consider radiology AT ALL before med school.. and didn't really consider it before 3rd year. I went into school thinking I would do either ER, trauma surg, plastic surg, neurosurg but never radiology. After starting 3rd year I slowly came to realize that radiology was right for me because I initially went into med school for the science. I wanted to learn everything about how the body worked and about diseases. And after first year, I knew I had to go into something that was very anatomy focused because that's what I love. And now that I'm sitting behind the computers in the dark room, I cannot possibly be happier.
So feel free to ask whatever and I'll try to check this most nights and answer any questions. Feel free to PM me also. And just a note --- radiology residency is basically 8-5 Mon-Fri. Weekends and holidays off unless you're on call which is typically 3-6 days per month depending on residency size.

Is residency really 8-5 in Radiology, w/3-6 call days, or is this highly dependent on the program in question? In seeing this: http://thedartmouth.com/2013/04/11/...it-against-dartmouth-hitchcock-medical-center, which was on Aunt Minnie as well, maybe some places have residents take a lot more call than others?

 

[DermViser]

I just want to say - radiology is pretty competitive - plenty of people are interested. But thanks for doing this.

 

[DrBowtie]

Is residency really 8-5 in Radiology, w/3-6 call days, or is this highly dependent on the program in question? In seeing this: http://thedartmouth.com/2013/04/11/...it-against-dartmouth-hitchcock-medical-center, which was on Aunt Minnie as well, maybe some places have residents take a lot more call than others?

Pretty much as you described with majority having NF months rather than traditional 24-30hr call. Obviously varies by program size and amount of hospitals covered.

Radiology is however a 24/7 operation similar to ER. Residents should expect overnight duty.

In the community, practices either rotate night call if relatively light, have dedicated night staff, or utilize domestic teleradiology for prelim or final reports.

 

[DermViser]

Pretty much as you described with majority having NF months rather than traditional 24-30hr call. Obviously varies by program size and amount of hospitals covered.

Radiology is however a 24/7 operation similar to ER. Residents should expect overnight duty.

In the community, practices either rotate night call if relatively light, have dedicated night staff, or utilize domestic teleradiology for prelim or final reports.

So then lifestyle as an attending after residency (esp. in private practice) is much worse than in residency. Are there any 8 to 5 Radiology jobs with infrequent calls or is that pretty much gone?

 

[DrBowtie]

So then lifestyle as an attending after residency (esp. in private practice) is much worse than in residency. Are there any 8 to 5 Radiology jobs with infrequent calls or is that pretty much gone?

There are varying degrees of lifestyle available with varying degrees of money. Plenty of rads still do no nights because they pay teleradiology.

The height of the 8-5 no weekend gigs are drying up do to cuts for stand alone outpt imaging centers with more consolidation to hospital based imaging.

 

[DermViser]

There are varying degrees of lifestyle available with varying degrees of money. Plenty of rads still do no nights because they pay teleradiology.

The height of the 8-5 no weekend gigs are drying up do to cuts for stand alone outpt imaging centers with more consolidation to hospital based imaging.

Why are stand alone outpatient imaging centers getting cuts while hospital based imaging not getting cuts for the same service?

So for the benefit of those reading, I guess, if lifestyle is a major concern for the medical student, then you don't recommend Radiology as these things easily change?

 

[DrBowtie]

Why are stand alone outpatient imaging centers getting cuts while hospital based imaging not getting cuts for the same service?

So for the benefit of those reading, I guess, if lifestyle is a major concern for the medical student, then you don't recommend Radiology as these things easily change?

I still think it has a better lifestyle than most specialties. Like I said most practices are not having everyone cover nights. As long as you aren't a dedicated night rad or telerad it's pretty much business hours plus your share of weekends. Procedure call varies widely.

 

[DrBowtie]

To answer your other question, Hospitals have a strong lobby and want the technical fees.

 

[DermViser]

To answer your other question, Hospitals have a strong lobby and want the technical fees.

Ah, yes, like facility fees for clinician procedures.

 

[bjb305]

Is it true that radiology mostly attracts introverts?

lol actually all of the guys at my program are pretty outgoing and laid back.. so no

 

[poopsicle]

What'd you do during medical school to prepare for radiology residencies?

 

[Aerus]

What were your typical study habits like for preclinicals?

 

[radman123]

I am a rad attending approaching mid career working in a desirable metro.

The job market in my area and within 1 hour is awful. We had one opening last year and had dozens of star applicants who comfirmed this. We hired a connected experienced rad. Look at recent workforce survey from ACR. More grads than jobs. This has been going on for 6 years roughly. Nothing is being done.

I take call once a week until 11 pm. My day is typically 9-10 hours. I work 2 holidays every year. I read non stop for my shifts. Not my defintion of lifestyle. The no call no weekend jobs are very rare these days. This is a busy field that runs 24/7.

Job stability is low as consolidations and takeovers (like my groups) are becoming more common. As an employee you can be fired like the secretary who works in your department. There have been rad layoffs in my system because of budget cuts.

 

[bjb305]

What'd you do during medical school to prepare for radiology residencies?

i didn't do anything in particular other than just study real hard.. i tutored a lot of anatomy which i think helps once you hit rads cause a lot of the anatomy i remember

 

[bjb305]

What were your typical study habits like for preclinicals?

i studied a LOT. read the lectures over and over again. for step 1 i did usmle Rx, kaplan, and uworld qbanks

 

[Gregor Wiesmann]

What kind of car are you going to buy when you're an Attending?

 

[bjb305]

What kind of car are you going to buy when you're an Attending?

lol nothing fancy.. i was never really into cars.. but i will certainly buy the most comfortable couch with an obnoxiously large TV and a hot tub

 

[Gregor Wiesmann]

lol nothing fancy.. i was never really into cars.. but i will certainly buy the most comfortable couch with an obnoxiously large TV and a hot tub

Okay, can you list your top three favorite hobbies outside of Medicine?

 

[bjb305]

Okay, can you list your top three favorite hobbies outside of Medicine?

running, hiking, biking probably.. climbing too

 

[Aerus]

i studied a LOT. read the lectures over and over again. for step 1 i did usmle Rx, kaplan, and uworld qbanks

I've heard of med students annotating First Aid and making tons of flash cards. Would you recommend any of that?

 

[bjb305]

I've heard of med students annotating First Aid and making tons of flash cards. Would you recommend any of that?

i took few notes in first aid.. it depends on your learning strategy. For me, just seeing it over and over again was what worked and I viewed rewriting things in the form of flash cards as a huge waste of time when I could've read the lectures another time thru. For others, writing it down is what helps them remember it. All depends

 

[bjb305]

I've heard of med students annotating First Aid and making tons of flash cards. Would you recommend any of that?

You also need to be careful with how you study if you take notes... let's say you take notes and all you study were your notes and not the original lecture/chapter and then what you actually took notes on really wasn't important to begin with... then you have a huge problem

 

[Mad Jack]

I just want to say - radiology is pretty competitive - plenty of people are interested. But thanks for doing this.

Rads has fallen pretty far. A lot of programs are accepting IMGs and DOs that never would have in the past due to a lack of USMD interest, largely owing to a job market that closely resembles what happened to path a few years back (too many residencies, not enough retirees, reimbursement cuts).