Am I in the Wrong Field?

[Glubad]

I’m an R1 who is really struggling in radiology. I had lower step 1 scores to begin with, and feel like I’m falling even further behind my coresidents. I try to study every day but am having difficulty concentrating and retaining information. I get very anxious when asked questions by attendings and on case conferences and almost always give the wrong answers even though everyone else seems to get everything right. I’m so tired of struggling through studying only to not see any fruits of my efforts when I am asked questions by attendings or in conference.

I had a personal situation that came up a few days before I started radiology that makes it very difficult for me to be in my current residency program location, and which honestly is probably contributing significantly to my difficulties in residency so far. If it had happened earlier in the year I probably would have applied for an NRMP waiver, but since it happened the week of my residency start date I’ve just been trying to power through. I’ve been trying to switch programs, but haven’t had any luck so far. Im now wondering if I need to switch specialties and if I’m maybe just not cut out for radiology. A large part of me is just considering quitting medicine altogether -I feel miserable and stressed out everyday, and I’m not sure how to fix it other than getting out of the situation (I do already see a therapist). I have an engineering degree from a fairly decent undergrad, so I could probably find some sort of job using that degree if I needed to.

I was so excited to match into radiology, and now I feel like I’m just failing at it. I’m not sure if I can survive another 3.5 years like this. I’m not sure how much of this would be solved by transferring programs and how much is just that this isn’t the right field for me. I decided on radiology fairly late in medical school, but I also have family in the field so I had a fairly good idea of what it was like prior to applying. I just might not have the aptitude for it.

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[guytakingboards]

I’m an R1 who is really struggling in radiology. I had lower step 1 scores to begin with, and feel like I’m falling even further behind my coresidents. I try to study every day but am having difficulty concentrating and retaining information. I get very anxious when asked questions by attendings and on case conferences and almost always give the wrong answers even though everyone else seems to get everything right. I’m so tired of struggling through studying only to not see any fruits of my efforts when I am asked questions by attendings or in conference.

These feelings are very common among first year residents. Almost the expectation. Radiology is not easy and the early learning curve is extremely steep. That anxiety sucks but it forces you to study. You won't remember stuff after one pass. This is a marathon that will take you through several passes of the same material before you feel confident in it.

It's irrelevant how your co-residents are doing (/how you *think* they're doing). You simply have no frame of reference. You've been in long enough where your attendings and/or program leadership have a sense of how you're doing. If you were that far behind, they hopefully would have already talked to you. If you are really concerned, consider touching base with a trusted attending or the APD/PD. They will tell you if you are behind your milestones and/or peers. If you haven't heard any complaints yet, you're probably within normal limits.

I had a personal situation that came up a few days before I started radiology that makes it very difficult for me to be in my current residency program location, and which honestly is probably contributing significantly to my difficulties in residency so far. If it had happened earlier in the year I probably would have applied for an NRMP waiver, but since it happened the week of my residency start date I’ve just been trying to power through. I’ve been trying to switch programs, but haven’t had any luck so far. Im now wondering if I need to switch specialties and if I’m maybe just not cut out for radiology. A large part of me is just considering quitting medicine altogether -I feel miserable and stressed out everyday, and I’m not sure how to fix it other than getting out of the situation (I do already see a therapist). I have an engineering degree from a fairly decent undergrad, so I could probably find some sort of job using that degree if I needed to.

This sucks. Sorry to hear this. It obviously makes everything more difficult on a day to day basis.

Re: leaving radiology and/or medicine in general, it's not ideal to make this decision when you're not in a good headspace. If you leave the specialty and/or medicine in general, there's no second bite at the apple. You won't be able to come back to it. So max out your options on making it work before you bail.

I was so excited to match into radiology, and now I feel like I’m just failing at it. I’m not sure if I can survive another 3.5 years like this. I’m not sure how much of this would be solved by transferring programs and how much is just that this isn’t the right field for me. I decided on radiology fairly late in medical school, but I also have family in the field so I had a fairly good idea of what it was like prior to applying. I just might not have the aptitude for it.

Back to the first point, many/most first year residents feel overwhelmed. In fact, it's the ones that aren't overwhelmed who are generally the concerning ones, cuz they seemingly don't understand how much they don't know and need to learn. If you got this far, very unlikely to be an aptitude issue. Very few people fail out of radiology because of aptitude/intelligence.

 

[GoPelicans]

Do you feel like you would like radiology after all the studying is done? It's hard to separate dislike of studying from your feelings of actually practicing the specialty but it's important to do. If you don't feel fulfilled by the day to day work the answer might be the field.

 

[Iamnew2]

These feelings are very common among first year residents. Almost the expectation. Radiology is not easy and the early learning curve is extremely steep. That anxiety sucks but it forces you to study. You won't remember stuff after one pass. This is a marathon that will take you through several passes of the same material before you feel confident in it.

It's irrelevant how your co-residents are doing (/how you *think* they're doing). You simply have no frame of reference. You've been in long enough where your attendings and/or program leadership have a sense of how you're doing. If you were that far behind, they hopefully would have already talked to you. If you are really concerned, consider touching base with a trusted attending or the APD/PD. They will tell you if you are behind your milestones and/or peers. If you haven't heard any complaints yet, you're probably within normal limits.



This sucks. Sorry to hear this. It obviously makes everything more difficult on a day to day basis.

Re: leaving radiology and/or medicine in general, it's not ideal to make this decision when you're not in a good headspace. If you leave the specialty and/or medicine in general, there's no second bite at the apple. You won't be able to come back to it. So max out your options on making it work before you bail.



Back to the first point, many/most first year residents feel overwhelmed. In fact, it's the ones that aren't overwhelmed who are generally the concerning ones, cuz they seemingly don't understand how much they don't know and need to learn. If you got this far, very unlikely to be an aptitude issue. Very few people fail out of radiology because of aptitude/intelligence.

I agree wholeheartedly with this advice. Most first year Rads residents feel overwhelmed as the amount of information to know is overwhelming and it's likely that the med school experience received was "chill" and residents now encounter a world of knowledge that they need to have that is unique and significant studying. I had the same feelings as OP when I was an R1. I also had a significant medical issue pop up relatively early in residency that made Radiology a. no go.

As you mentioned, I don't think OP should make a rash decision as the typical R1 will feel inept and overwhelmed, that's typical. However it is possible that Radiology is not for the OP and that's ok. It certainly wasn't for me and I'm glad I switched. But that decision needs to be made with careful thought and consideration. As someone said make sure it's truly the field that you don't enjoy - sometimes lack of fit is program specific sometimes it's field specific. Make sure that your personal situation is not what's making you be unhappy in the field.

There are certain realities such as significant studying, large volume, not much patient interaction outside of IR that is true of Rads. If those issues are at the core of your unhappiness then it might be necessary to change fields. It is possible you might need to go through the match again - I had to. But there is no point in staying in a residency if you don't like the field. It's not just the 3.5 years - it's the next 30 years that you have to think about. Residency ends. The rest of your career is decades long. I decided I couldn't see myself for 30 years doing Rads and switched, and I'm pretty happy. But take some time and don't make a rash decision.

 

[GoPelicans]

I agree wholeheartedly with this advice. Most first year Rads residents feel overwhelmed as the amount of information to know is overwhelming and it's likely that the med school experience received was "chill" and residents now encounter a world of knowledge that they need to have that is unique and significant studying. I had the same feelings as OP when I was an R1. I also had a significant medical issue pop up relatively early in residency that made Radiology a. no go.

As you mentioned, I don't think OP should make a rash decision as the typical R1 will feel inept and overwhelmed, that's typical. However it is possible that Radiology is not for the OP and that's ok. It certainly wasn't for me and I'm glad I switched. But that decision needs to be made with careful thought and consideration. As someone said make sure it's truly the field that you don't enjoy - sometimes lack of fit is program specific sometimes it's field specific. Make sure that your personal situation is not what's making you be unhappy in the field.

There are certain realities such as significant studying, large volume, not much patient interaction outside of IR that is true of Rads. If those issues are at the core of your unhappiness then it might be necessary to change fields. It is possible you might need to go through the match again - I had to. But there is no point in staying in a residency if you don't like the field. It's not just the 3.5 years - it's the next 30 years that you have to think about. Residency ends. The rest of your career is decades long. I decided I couldn't see myself for 30 years doing Rads and switched, and I'm pretty happy. But take some time and don't make a rash decision.

How many years did you do radiology before switching?

 

[Iamnew2]

How many years did you do radiology before switching?

Less than a year.

 

[letmebe]

Hey, I’m sorry you’re going through this. I understand how tough it is. The whole thing is exhausting and unfortunately as an R1 the end line feels so far away.

I’m an R2 now. You can look up my posting history and you’ll see what I was/am going through. I’ve reached out to many many people to get their perspectives on things.

Truth is if you search for people who love radiology you’ll find them. And if you search for people who regret radiology you’ll also find them. The caveat is, many people who regret their decision, end up having to come to terms with their decision and in doing so don’t really verbalize their feelings on the matter.

The typical scenario that plays out for people who are on the fence is the following:

R1: “I’m so lost. This is exhausting. I’m not even useful to the workflow. My med school friends are managing patients and doing night call on their own and getting ready to apply for fellowships while I’m trying to figure out how to read a CXR”.

R2: At this stage feelings are on a spectrum. You’ll realize whether the field clicks with you or not, or you could be anywhere between those two extremes. Depending on the person, you’ll still feel that there is a tremendous amount to be learned. But, at minimum, it gets a little more interesting to have the knowledge. As in, even if you were in a totally different field, it feels cool or satisfying to be able to understand studies. The problem at this point is, if you do not make up your decision soon enough to switch, you basically will enter the year where you have to start studying for your boards.

R3: You’re stuck this year at your residency and have boards at the end of the year. Thoughts will probably be “let me just finish my board exam. It’s such a hassle to switch. This is the hardest year if I get through it things will probably improve so much. One more year after this and I would be done with residency any way. I’ll just power through it’s the safer option and will allow me to go for decent jobs.”

R4: This is the last year and is considered chill at many programs. Just finish it and have this residency under your belt at this point and may be consider another specialty afterwards.

As you can see, I highly highly suggest you make a decision at the minimum before your second half of R2, preferably by late R1.

No one can make that decision for you.

I totally agree with the notion of figuring out whether you hate studying or the field itself. Ask yourself, can you envision living the life of the average attending you see or know. This helps somewhat clarify whether it’s a problem with the field.

It’s definitely a tough spot and I really wish you the best.

 

[Tiger100]

It all comes down to your perspectives and expectations in life.

People see things differently. In these kind of decisions, some people are more logical and some people are more emotional. For example, some people marry another person based on logic (and many of them can be very happy) and some people marry based on love.

Similarly, some people consider their career something very special that they have to love and some people have very practical expectations (good hours, good pay and good balance ). Generally speaking, people in certain surgical fields belong the the first category and many people in radiology, dermatology, some surgical subspecialties, rad onc and etc belong to the second category.