Feels like there's still some reason I'm missing for people not to go into rads... Can anybody shed some light?
I've thought about this a lot and our "rads group" in medical school during 4th year would always talk about this. I think there are a few big things:
1. Most med students are "traditional" and have been a student their entire life. They are immature (not in a derogatory sense) in that they've never held a real job before. I think they get caught up with the excitement of the specialty they're interested in (especially the surgeons) and forget to genuinely consider the impact of the job on their future life. Trauma surgery was BADASS when I rotated as a student - it was by far my favorite rotation (as was surgery in general) but guess what - who's going to really enjoy waking up at 3:30 AM to respond to your 5000th MVC trauma on a Saturday night when you're 50 and married with 3 kids? Not many people. I don't think people understand that medicine will eventually become "just a job" like everything else given enough time. We aren't better than anyone else. Medicine isn't holy. You have to find something that's not only intellectually stimulating but
sustainable. I think part of the problem is everyone pretends like medicine is somehow sacrosanct and you must have a "calling" to be a physician... But let's be honest here - for 99% of people that's not the case, especially in today's day and age with EMR and corporate commercialization of medicine run by bureaucrats (anyone else hate all the social work BS we have to do as physicians on general medicine?) and the shift toward a more algorithmic approach to medicine (think Up-to-Date). Very few physicians that are unhappy with their specialization own up to it, preferring instead to hide beyond their prideful facade, which just perpetuates the problem.
To add to this, I think people underestimate how certain specialties will affect their future self. I think the
general attitudes of the people in a specialty says something very important. We all know surgeons that are miserable, divorced, with poor relationships with their kids/spouses - they're a dime a dozen. Often we hear the nurses, techs, residents, and students talk sh** behind their back about how mean they are. Do you really want to surround yourself with people like this? Sure, self-selection is a component, but it's inevitable that the specialty you go in to will also mold
you - you'll be around them for years, at the very least. Radiologists are some of the friendliest and happiest group of physicians I've worked with, and I think surrounding myself with this group of people will positively affect my future. Most people probably (wrongly) see themselves as immune to this sort of outside influence.
2. I think most people don't want to sit in a dark room all day, especially the women. I think it's really that simple - most people just want a bit more human interaction than most DR jobs will provide. Sure, you can end up as an attending at a large academic institution with a huge reading room but that's not the impression most people get. Lots of people see dark rooms as depressing.
3. I think another big one is that it's hard to fully grasp what's going on in the radiologist's head while he's reading images and therefore it's difficult to appreciate and enjoy the work. Unlike many other specialties (like medicine) where the med student instantly sees a
direct connection between what they're learning (e.g. COPD) and what they see as a third year (lots of COPD), lots of the knowledge radiologists draw upon when working isn't really taught in medical school. Take a look at a basic chest x-ray book like Felson's and you start to learn so many clever tricks or interesting tidbits of physics that help you piece together what's
actually going on with that image - silhouette sign helping differentiate consolidation in different lobes that overlap on AP imaging, or figuring out which is the L or R diaphragm on a lateral. What about figuring out how to tell if the patient is rotated and to which side? All are very basic questions that have fascinating solutions, and none of them are obvious in our education. Most people see a CXR and think "lungs, ribs, white stuff" - it's really unfortunate. In short, I think medical students have to put in much more effort to fully appreciate the rewarding aspects of radiology as compared to almost every other specialty whose perks are more or less obvious.
4. And of course the other ones mentioned previously also play a role. Competitiveness, wanting patient interaction, prestige (DR definitely attracts people comfortable staying anywhere BUT the spotlight), etc... I guess there are some people who probably genuinely avoided DR because of the threat of AI but I don't think they are the sharpest tool in the shed.
