Radiology Musings...

[ACanOfCortisol]

These may come across as really stupid questions, but I'm new to this. Please bear with me.

- What does a Radiologist do? I have only a basic idea of what a radiologist does, and would like more info. Are they diagnostic physicians / therapeutic physicians or both?

- When (in which year of medical school) do you declare your intention to pursue Radiology?

- What is the difference between Radiology and Radiological Oncology?

- What's the average length of a radiology residency? Would I be a General Radiologist at the end of the residency, and have to spend some more years in residency, if I want to specialize (say in pediatric radiology)?

- How is the job scene for General Radiologists as compared to specialists?

- How does a typical day in the life of a radiologist go? Is it very high - pressure / demanding / time - intensive?

Please don't get me wrong with this last question. I mean to do my best by my future patients, but I also have a spouse and a young child and I want to avoid time-intensive and unpredictable specialities (such as OB/GYN)

I have so many questions, because I don't see as many discussions about Radiology as I see about other specialities. I am basically really confused about this entire field and the career options in this area.

Thanks in advance for your time, answers and patience.

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[fedor]

Your questions are very broad and a search would have answered many of them. check out iserson's book about residencies. it will answer a lot of your questions.

Radiologists are primarily diagnosticians but interventional radiologists do procedures and can be considered 'therapeutic'

Most radiologists spend the majority of their time reading scans (xrays, mri, ct, mams, etc.) and the work, especially in private practice, is extremely hard core -- there is no down time and there is plenty of pressure to read fast.

You declare your intention to enter radiology like you do with all the other specialties, the beginning of year 4 all the students participate in match and go on the interview trail. Then you have 1 year of intern (transitional year, prelim surg, prelim internal medicine) then 4 years of rads residency. after that you can continue on to fellowship if you like. there are 44 pediatric radiology fellowship programs according to freida.

the job scene at the moment is excellent for radiologists. however, by the time you finish medical school and residency (is you do decide on mstp it will be about 12 years before you're done) things can change. these things are very cyclical.

radiology is primarily diagnostic while radiation oncology uses radiation to treat cancer. they are very different specialties.

typical day in private practice is very high pressure, the hours i would say are about 55 hours a week on average, but rads are expected to read on their own both during residency and afterwards. it's a much more difficult specialty than you imagine. after a day at the office grinding out scans, most radiologists are exhausted.

if you are concerned about time intensive specialties, i recommend something other than radiology. allergy/immunology would be an excellent choice. dermatology also if you're able to match into it. check out the Freida site and their overviews of the specialties.

These may come across as really stupid questions, but I'm new to this. Please bear with me.

- What does a Radiologist do? I have only a basic idea of what a radiologist does, and would like more info. Are they diagnostic physicians / therapeutic physicians or both?

- When (in which year of medical school) do you declare your intention to pursue Radiology?

- What is the difference between Radiology and Radiological Oncology?

- What's the average length of a radiology residency? Would I be a General Radiologist at the end of the residency, and have to spend some more years in residency, if I want to specialize (say in pediatric radiology)?

- How is the job scene for General Radiologists as compared to specialists?

- How does a typical day in the life of a radiologist go? Is it very high - pressure / demanding / time - intensive?

Please don't get me wrong with this last question. I mean to do my best by my future patients, but I also have a spouse and a young child and I want to avoid time-intensive and unpredictable specialities (such as OB/GYN)

I have so many questions, because I don't see as many discussions about Radiology as I see about other specialities. I am basically really confused about this entire field and the career options in this area.

Thanks in advance for your time, answers and patience.

 

[Law2Doc]

Radiologists are primarily diagnosticians but interventional radiologists do procedures and can be considered 'therapeutic'

Most radiologists spend the majority of their time reading scans (xrays, mri, ct, mams, etc.) and the work, especially in private practice, is extremely hard core -- there is no down time and there is plenty of pressure to read fast.
...
the job scene at the moment is excellent for radiologists. however, by the time you finish medical school and residency (is you do decide on mstp it will be about 12 years before you're done) things can change. these things are very cyclical.
...
radiology is primarily diagnostic ...

Agree with the above, but would add that due to the amazing changes in technology, radiology is one of the fastest evolving fields, and it is a pretty safe guess to say that what is called radiology today might just be ancient history by the time you get to practice. While x-rays have been around for some time, inventions like MRI have only been around for a handful of decades, and before that CT and ultrasound were the newest toys. (I think that tricorder thing from Star Trek is coming next.) I would also note that while reading films/scans is currently a major part of a radiologists job, there is a constant push ("turf war") of radiologists pushing their areas of practice into the more interventional areas. Radiologists already do a lot of procedures that were probably under the control of vascular surgeons a few years back, and will likely make inroads into various other surgical areas due to the ability to see into the body real time. Thus I suspect it will be one of the more competitive specialties for some time. But that is just my uninformed guess.

 

[fedor]

Agree with the above, but would add that due to the amazing changes in technology, radiology is one of the fastest evolving fields, and it is a pretty safe guess to say that what is called radiology today might just be ancient history by the time you get to practice. While x-rays have been around for some time, inventions like MRI have only been around for a handful of decades, and before that CT and ultrasound were the newest toys. (I think that tricorder thing from Star Trek is coming next.) I would also note that while reading films/scans is currently a major part of a radiologists job, there is a constant push ("turf war") of radiologists pushing their areas of practice into the more interventional areas. Radiologists already do a lot of procedures that were probably under the control of vascular surgeons a few years back, and will likely make inroads into various other surgical areas due to the ability to see into the body real time. Thus I suspect it will be one of the more competitive specialties for some time. But that is just my uninformed guess.

The new techology is a small factor in how competitive radiology is. Radiology has seen rapid technological advancement for the last 40 years. However, in the last 10 years alone, radiology residency competitiveness has varied widely from being very competitive to being rather easy to get into.

The turf war isn't peculiar to radiology. However, I would like to point out 2 types of turf issues in radiology 1) diagnostic -- clinicians reading their own scans (orthos, neurologists, etc.) 2) interventional -- cardiologists putting in stents.

If you're a private practice radiologist, you're most likely going to be strictly diagnostic. Your group may have an interventional rad to take care of the procedures. So the competition from vascular surgeons, INR trained neurologists or neurosurgeons, is really nothing to be too concerned about if you said you're interested in a nice lifestyle (by that, I assume you're looking at diagnostic rads and not interventional). Interventional cardiology in private practice is almost entirely in the hands of cards now, and it hasn't effected the salaries of radiologists much.

The more pressing issues, imo, are on the diagnostic side. 1) Telerad from India 2) Self-referral from shady orthopods with ****ty imaging equipment 3) Neurologists and other clinicians trying to read their own scans. However,I think all these issues are exaggerated. Today's gunner radiologists w/ 240+ Step 1's and AOA are hardly the type to surrender these issues w/o a fight.

To the original poster, have you considered pathology? While I'm heading towards radiology myself, I consider pathology to be a hidden gem. It has an easy match, solid compensation, great lifestyle, less egos than the other specialties, and most importantly, it satisfies the curiousity of those most interested in medicine.

 

[Law2Doc]

The more pressing issues, imo, are on the diagnostic side. 1) Telerad from India 2) Self-referral from shady orthopods with ****ty imaging equipment 3) Neurologists and other clinicians trying to read their own scans. However,I think all these issues are exaggerated. Today's gunner radiologists w/ 240+ Step 1's and AOA are hardly the type to surrender these issues w/o a fight.
.

It's not the gunners who will win these fights for the radiologists -- its the lawyers. When things go bad, it's pretty indefensible to stand in front of a jury and have to admit that the person who read the films was not a US licensed, board certified radiologist.

 

[(nicedream)]

typical day in private practice is very high pressure, the hours i would say are about 55 hours a week on average, but rads are expected to read on their own both during residency and afterwards. it's a much more difficult specialty than you imagine. after a day at the office grinding out scans, most radiologists are exhausted.

That's the first time I've heard radiology depicted as a tough lifestyle. Usually it's considered to be part of the ROAD to happiness (rads, ophtho, anesth, and derm).

 

[fedor]

That's the first time I've heard radiology depicted as a tough lifestyle. Usually it's considered to be part of the ROAD to happiness (rads, ophtho, anesth, and derm).

Rads has changed a lot over the past 10 years or so. Reimbursements were cut (and will be cut even more) but radiologists managed to compensate by increasing efficiency. They read much faster now than they did a few decades ago. Every year many radiologists are asked to leave their PP groups because they can't read fast enough. Luckily for them, there is a shortage of radiologists looking to go into academics at the moment.